Does Anyone From Your LTC/SNF Meet Patients Prior To Admission?

november17, ASN, RN · Dec 9, 2009

I am curious what your protocol is for accepting new admissions to your LTC/SNF. In the facility where I work, the social service/admissions person (not a nurse) simply gets all the info from the hospital over the phone, and a decision is made based on that. No one actually goes to the hospital to meet the prospective admission, review the records, or speak face to face with the nurses at the hospital

I don't work at an LTC, but I'll just chime in that there is one facility in the area here where the admitting physician from the SNF actually shows up and evaluates the patient (really oldschool). Most of the other ones have marketing people that stop by, meet the patient, and talk with the family. I'm not aware of any that don't have someone do a face to face prior to admission, at least I've never discharged a patient to a place that doesn't. Sounds kinda odd to me.

Bug Out, BSN · Dec 9, 2009

Typically our admissions person goes out and physically sees the pt before admitting, lately our DON personally assesses the pt.

During report the admitting Nurse has an admissions form to fill to help the admitting Nurse make the decision if he/she can accept the pt.

kristinlpn · Dec 9, 2009

Same as yours. No one sees the patients before admission.... It would be nice though in a perfect world!

CoffeeRTC, BSN, RN · Dec 9, 2009

We have an admissions person who handles these. He is more of a sales person and has to meet numbers (keep the census up) This new person has a medial background (not a nurse) so he is aware of things and flags. (meds such as haldol, Ativan etc) Sadly, from talking to this admissions person and others..it is more about keeping the numbers up and sometimes some "bad" admits happen because they look good on paper.

Most of the out of facility work that they do is more sales related and talking to docs, sw etc and not seening the actual patient.

nursejoy1, ASN, RN · Dec 9, 2009

Up until the last two years, my facility was the same as yours- mostly clerical- no real assessment beforehand. Now, though we are fortunate to have an "Admissions Outreach Team"- which consists of a marketing guy, an RN and a social worker. This has worked out well.

southernbeegirl, BSN, RN · Dec 9, 2009

we have a nurse liason (sp?) at the hospitals but that doesnt stop us from getting the geropsych patients at all. the reason is that the company will NOT let them turn anyone down. it's all about the census, the evermighty dollar...the dont give a hoot about the nurses on the floor.

wyogypsy, RN · Dec 9, 2009

I have worked for LTC facilities that did both. The ones that send a nurse to evaluate the patient usually have a waiting list and can pick and choose who they let live at their facility. The ones that don't? Well, they do not turn anyone down as it is all about the dollar; and usually are not a facility with a waiting list.

CapeCodMermaid, RN · Dec 9, 2009

At my last facility we had an RN screener. She was as dumb as toast and never actually looked at the patient. She'd call up every week or so and ask the same questions: Do we do IVs, can we do IV push. At my current place, we are 60 miles away from the hospital so we don't get to see the patients before we accept them. We have access to the hospital computer and I have learned to read between the lines. I'm developing more of a working relationship with the case managers there so they now tend to be a bit more honest with me about the residents they want us to take.

makes needs known · Dec 9, 2009

We have an RN admission team (2 nurses) that go over to the hospital to assess for new admits. We are a ltc facility but our floor has been slowly turning into a rehab floor. We still get some patients who end up becoming long term care. They give us prior information about the new admits. But sometimes it's real crazy when we get 3 new admits within an hour in the afternoon. We need to get their med orders cleared by our Dr, order meds from pharmacy, and complete a bunch of paperwork and assess new patient. Very busy evenings.

Nurse!Nurse!Hello? · Dec 10, 2009

For the first few years I worked at my facility, the assistant DON would go to the hospital to screen potential admissions. I have noticed that now it seems we accept just about anyone, sight unseen. I guess it's a financial issue, as others have said. It's a shame though-- it seems we are spending more time and more resources monitoring agitated and restless people with 1:1 supervision. It takes time away from the other patients and residents. I see that we are not the only facility that is accepting people regardless of whether there is staffing available to keep them safe. Quality of care has really taken a nosedive the past few years, unfortunately.

sasha2lady · Dec 21, 2009

Hmm.....we have a social worker and a "marketing" person who take in our admits.....we, the nurses have NO idea an admit is even coming 99% of the time til we see them roll in on a stretcher or someone comes and tells us a new person just got there. Once in blue moon and I do mean "once" either the SW or the marketing chick will go to the hospital but it mostly gets done via phone or faxes. They take whoever and whatever, doesnt matter. They have taken peg tube people when we were out of tube feedings or didnt have the kind they needed or we did have it and it had been locked away from the nurses and expired so we then have to jump thru hoops to get it changed to something we can use. The SW and marketing person have no nursing knowledge what so ever...they are just told by administration to take them in. We have had all kinds, even younger adults who only came to us after being beaten up by drunken doped up family members...we've gotten drug addicts, alcoholics, schizo's, bipolar, psych ,...you name it. Then once they get handed off to us they expect us to work miracles on them. Thats just on the rehab unit.