Admissions...who decides?

  1. Who in your facilities decides who is admitted? We're in the middle of a transition (which really means fire the person who knows what they are doing and hire a bunch of non-clinical people to screen potential admits) and I am worried about how this is going to put us at risk.
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  2. 13 Comments

  3. by   Nascar nurse
    (Hey where have you been? Not seeing you around much)

    I am very lucky. I have an external person that makes rounds at the local hospitals. She is an RN that has been in the business a long time and has her act together. She seems to really get the behavior problems, is up on her expensive meds, etc. If she is good with the initial info, she gathers info and sends to our internal admission person (who is an experienced/smart LPN). The internal person also looks over the info and sends payor info on to the business office to ensure coverage.

    In the rare cases that the 2 of them are uncertain, they will bring to me for the final say. As I said, I am very lucky because between the 2, they really know what they are doing and if it gets to me and if I say "No" - they both are just fine with it and it is a done deal at that point.

    I start with a new administrator in a couple days and I hope they keep their fingers out of a system that is working so well.
  4. by   CapeCodMermaid
    I've been under the radar so to speak. I'm glad things are working out for you. The people my company has slated to be screening....one nurse in the bunch of 10...one is an xray tech and one is a CNA. They tell me I have the final say but I'll let you know what happens the first time I say no thanks.
  5. by   VivaLasViejas
    Wait---doesn't an RN have to do a PASRR before admitting a resident to a nursing facility? Maybe that's just in my state (OR), but it is a requirement for both SNF and custodial care, therefore the administrator (or worse, the sales manager!!) doesn't get to make an admission decision without the blessing of at least one registered nurse.

    Wish it were the same for assisted living....but I've got a fantastic boss who was an EMT for 20 years prior to becoming an administrator, so he doesn't bring people in without running it past me if they're medically or psychiatrically complex.
  6. by   CapeCodMermaid
    The language in Massachusetts says "the licensed professional" must complete the PASARR...RN,LPN,or Licensed social worker.
  7. by   Nascar nurse
    Quote from CapeCodMermaid
    The language in Massachusetts says "the licensed professional" must complete the PASARR...RN,LPN,or Licensed social worker.
    Indiana has the same language. Here the process is initiated in the hospital by one of their licensed professional.
  8. by   CapeCodMermaid
    The hospitals here flat out refuse to do PASARRS.
  9. by   RanieRN
    We go from screener in the hospital to our admissions coordinator. She checks out the insurance stuff. The screens are then checked out by the DNS, ADNS, or SDC. If the coordinator can't find any of them, she tracks me down.

    Recently, our census started circling the drain, so the screens haven't been scrutinized as much as they used to.

    The hospital screener told us the hospitals have been discharging to home more as opposed to sending them to rehab first. Anyone else find this to be happening?
  10. by   Aem1215
    I sympathize with your nervousness! Neither of my admissions people are clinical. My company employs people who are positioned in our feeder hospitals, some are nurses, some aren't. What chaps me is on the rare occasion I do say no, its a national crisis!
  11. by   noc4senuf
    My Med Records person handles admits.... been doing so for quite some time. One of my supervisors looks over the assessments and okays them. Any questions?? I have the final say on everyone.
  12. by   mpstad
    Could you clarify what med rec does to "handle admits"? I'm reviewing our admission process and med rec is fairly involved but I want to be more specific. Do you work with a med rec consultant? I work in ltc in se wisconsin. Thanks.
  13. by   noc4senuf
    She takes all the referrals, assigns the beds, checks payor sources, etc.
  14. by   HelenaHandbasket
    I worked as an onsite evaluator for a LTC company. I did get this feedback as well from the Care Coordinators in the hospital. Home Care has stepped up their game in terms of what services they can and will provide in the home setting. Why send a patient to Rehab when they can get the same services cheaper at home?

    My boss(es) felt I wasn't doing enough to improve census. Aside from kidnapping patients from the hospital, the only option we had was to improve our clinical offerings. They resisted. I was laid off due to the low referral rates.

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Admissions...who decides?