Families refusing certain SNF

[EllbellRN]

Hi,

I'm interested in similar experiences where a family refuses the bed offer for a particular SNF. We always ask for 3 choices from families and place referrals. Often times a bed is offered at one of the choices, but the family refuses to be discharged because they want to "wait" until a bed is ready at the SNF of their first choice. Is there a Medicare regulation that says a family must accept the first bed offer within 20 miles? Someone mentioned this reg recently, but I'm not aware of it. Also, are any CMs handing out notices to patients when they are admitted to OBS and NOT Inpatient? We have yet to do this at our facility. It seems at our facility, the patients "rule to roost". Thanks for any input.

[illsince83]

I run into this situation many times at work. You must tell the patient that you cannot delay discharge on matters of preference and that you fulfilled your obligations to them by providing choices in discharge by giving 3 SNFs. Have a HIN letter handy and let them know that they have the right to appeal their discharge but may be liable for the hospital bill from the time the hospitalist deems them appropriate for going home (or in this case going to SNF). More often than not, the mere thought of having to pay for their hospital stay out of pocket will scare them away from delaying. Also let them know that once discharged to a SNF, they have the ability to transfer if arrangements can be made

[elkpark]

I run into this situation many times at work. You must tell the patient that you cannot delay discharge on matters of preference and that you fulfilled your obligations to them by providing choices in discharge by giving 3 SNFs. Have a HIN letter handy and let them know that they have the right to appeal their discharge but may be liable for the hospital bill from the time the hospitalist deems them appropriate for going home (or in this case going to SNF). More often than not, the mere thought of having to pay for their hospital stay out of pocket will scare them away from delaying. Also let them know that once discharged to a SNF, they have the ability to transfer if arrangements can be made

This is what happens at my hospital(s). The CMs tell families that they will be happy to work with them to try to find a facility of their choice, but that is not a reason to delay discharge.

[DavidKarl]

An easy way to affect a transfer to a different SNF, once admitted? Just raise. HELL. The first place will pull out all of the stops to help you out.