So many hospitals I work with have greater length of stay for those patients where a hospice referral was made. Here are some actual dates from a hospital in the southeast that mirrors other hospitals.
This hospital made 201 hospice referrals during a 12 month period. The LOS on these hospice referrals was 13.3 days, ouch! The hospital’s overall LOS is 4.9 days. Why the big difference? A few thoughts are below along with some possible measure on how to lower that LOS.
Hospitals and Health Systems still don’t get hospice! I am working with several hospices that are trying to forge deeper working relationships with their local hospitals. Hospice can be such an important tool in:
- Decreasing their Mortality Stats (the actual number and related Length-of-Stay)
- Maximizing their DRG payments
- Reducing inappropriate hospitalizations
- Creating a new stream of revenue
Billable hours are the economic engine that drive Personal Care Home Health (Private Duty) companies. I know this well, because I actually own a Personal Care Home Health Company called Homewatch CareGivers, www.thehomecareexpert.com and my challenge over the years has been understanding how best to drive billable hours.
My initial efforts started with a traditional sales model. I had three sales people working the segments of Geriatric Case Managers, ElderLaw Attorneys, Assist Living Communities and the well. Maybe I didn’t have the right people and/or I didn’t do a good job with training, but the results were poor.
The 1st QTR of 2015 flew by! I hate to say it, but planning for 2016 will be here soon. So how was your growth performance for the 1st Quarter? Did you meet your organization’s referral, admission and ADC growth goals? Does your organization even have growth goals? There are many that don’t- and without establishing goals, an organizations growth cannot be measured.
How strong is your core? Having a strong core of Nurse Case Managers is key to growth and success. And having a consistent regular team of Case Managers is fundamental to providing quality services and a set of referral sources who trust your hospice. So how do you strengthen your core?
I am a having a bad month!! I wrote in a post a few weeks ago about how difficult it was to get one of my Homewatch CareGivers clients hospice care. Well it happened again – This time with another hospice in my community, one I respected very much and for whom I once worked. Here is what happened and some lessons learned for all of us.
Are there still opportunities to serve more people and grow?? I read an article by Rich Chesney who suggests that hospice is stuck in a rut. The article took an 11-year snapshot of hospice utilization, only to find that while hospice utilization was growing at the beginning of the period, that utilization seems to have plateaued. As in most industries that have reached a mature state in their development, doing things the same old way to serve more patients and grow has only gotten hospices limited growth. Add to that, increased regulatory scrutiny and pressure, and hospices are finding growth harder to come by and they become even more conservative about who they accept and keep on service. The data in Mr. Chesney’s report shows that the opportunity for growth is there. And I agree with him. The challenge is to create better ways to serve referral sources, provide a superior patient and family experience and truly understand the value propositions for each segment you are targeting and deliver.
Recently I have heard some whispering around pay per visit for hospice visits. This is mostly coming from organizations that have a skilled home care business where pay for visit is an option. As you might imagine, this is causing quite a rise in eyebrows in the hospice community. What are your thoughts?
The first 24-hours when a patient and family start hospice service is key to the patient experience and also related to the rate of revocations. The best way to grow your census is not to lose any business you already have. Providing the most outstanding service and care within the first 24-hours is a key strategy for growth.
Whenever an organization hits the wall in terms of growth, or worse yet, growth starts to decline, everyone is quick to point to the external environment. Completion has increased, the regulatory environment has shifted, our customer base is fickle, etc. While some of these may be true, I submit to you that it is more of the internal environment that causes an organization to stop growing. Those “invisible velvet gloves”, broken processes, lack of people’s sense of urgency, no team work, etc. are more in control of your “the spigot of growth” than you can imagine. This largely has to do with two important factors. The first, there most likely is not a strong positive culture of growth in the organization. And, second, there most likely isn’t a well-developed and articulated growth/referral development plan to follow.