If the resident goes to the hospital, you lose money. It's that simple.
All studies show that residents do better overall when treated in a familiar environment so it's best for them to be kept where they live (your facility) and treated there. I discuss with the docs what we can and cannot do in the SNF. We do labs slower but they get done. We do IVs, xrays, suctioning, oxygen....everything except ventilators.
I have a weekly report to send to corporate which explains what the symptoms were, which doc sent them, which shift they went out on, were they admitted and what was the diagnosis, name of the RN who assessed them before they got sent out and what we tried in house before we sent them.