Collaborative effort would be patient benefit’
A prescreening assessment form developed for skilled nursing facilities (SNFs) by the National Association of Subacute and Postacute Care (NASPAC) could be used collaboratively with discharge planners to provide the most appropriate care for patients, says Diane Brown, a member of the board of the Vienna, VA-based organization and president of JSC Inc., a Boston firm that specializes in education, consulting, and training for post-acute care.
But getting discharge planners to use the form — which gathers 108 pieces of information and requires two to three hours to complete — is "a hard sell," Brown adds. "[They think], Why should [I] use the tool and do all the work?’
The way the process typically works at present, Brown explains, is that a nurse assessment coordinator from the SNF goes to the hospital to physically examine the patient and gather the information before determining if the facility will accept the person.
However, at least one acute care provider — Yale New Haven (CT) Hospital — uses the tool to provide information for the SNFs in its catchment area, she points out. In that case, the SNF would send a person to the hospital to examine the patient only "if there’s a very unusual case."
Discharge planners and nursing home staff completing and reviewing the form together would be "a marvelous patient benefit," says Brown, who helps develop the NASPAC curriculum and serves as an instructor for the organization. "We teach certification for nurse assessment coordinators, which is a two-day program, and we designed the tool to teach them how to do the process."
The tool uses the language of the minimum data set (MDS) and the prospective payment system, she notes, and is more extensive than most other forms.
"Once [SNFs] accept a patient, they are legally responsible for that person. They are looking at a per-diem rate, and if the person is on an expensive medication they don’t have, they may spend every bit of the [reimbursement] on medication. This is a useful tool to get everyone thinking about the functional needs of patients as they leave one setting and go to the next," Brown adds. "The more you understand functionality, the better you are able to place the person appropriately," she says.
[For more information on the NASPAC prescreening assessment tool, contact the organization at (703) 790-8989 or Diane Brown at (888) 669-8123.]