Never underestimate the importance of having a coordinated Post-Acute Network of Skilled Nursing Facilities. You may be familiar with a hospital that has its own Post-Acute Network, Senior Network, or Community Collaborative. These are all different names for a similar approach.
The goal is to set an expectation for your post-acute providers that encourages a commitment to quality, communication between providers, and working together to prevent readmissions.
Some hospitals also invite home health and hospice providers to their post-acute network. In my experience, when a hospital includes multiple levels of post-acute care in the meeting, the group becomes too large and has too many competing interests.
Some organizations have taken to having a post-acute network meeting for Skilled Nursing Facilities (SNF) and a separate meeting for home health, home care, hospice, palliative care, and assisted living providers. This would also be an effective approach. However, if your network included a hospital-owned home health and hospice provider, it is much easier to have one Post Acute Network meeting and include the hospital-based home health and hospice providers along with the SNF’s.
The Good…When does a Post-Acute Network (PAN) Work
A post-acute network is a no-brainer for every acute hospital. Stick to the basic rules of:
- Hosting it at the hospital, not off-site!
- Monthly is too often, quarterly is not often enough. Meeting every other month is the key!
- Do not require a massive amount of data to be collected by members (they do not have the resources and they often just make it up), keep it simple and manageable
- Feed the attendees a decent lunch or breakfast
- Make sure you have the right attendee. The marketing and admissions representative from the hospital is only welcome if accompanied by the Administrator and Director of Nursing. If the admissions person is a clinician (RN/LVN) who actually performs Evals have some latitude on this rule. But the point is the SNF’s leadership needs to prioritize this!
- Make sure when attendees leave they understand the whole point of the PAN is to enhance communication to prevent avoidable hospitalizations.
The fact that the hospital is hosting the meeting in itself suggests that hospital leadership is committed to improving coordinated care and preventing avoidable hospitalizations. But if the SNF’s blow it off, which shockingly many do, be sure to call them that same day and let them know that “we are happy to remove your facility from the invite list and permanently un-invite you from future meetings if you think the every-other-month meeting is that unimportant,” (they will get the point!).
The Bad…When does a Post-Acute Network (PAN) NOT Work
Let’s simplify this concept: The hospital hosting a PAN meeting is simply the hospital flexing its muscle, making sure the post-acute providers in the region are paying attention. No disrespect to post-acute providers, but hospitals have tremendous resources and are used to good processes and consistency. Having been a post-acute provider, resources and staff are thin, so good processes are often difficult to implement and sustain.
With that said, attending a bi-monthly PAN meeting enhances this communication between providers and can help level-set expectations. Here are a few things that will guarantee the PAN fails:
- The hospital having unrealistic expectations about what the SNF’s are capable of from a data collection and EMR standpoint
- Do not host the meeting offsite – it must be at the hospital
- Do not host monthly or quarterly, but every other month
- Do not require a boatload of data, even if automated by the EMR
- Do not skimp on the food. Feed them a good meal and facilitate a worthwhile conversation.
- Keep it to 75 minutes – with at least 15 minutes for networking
If your hospital does track readmission by facility, feel free to share the monthly stats but this can work for you or against you; it has occasionally backfired.
Last but not least, the SNF’s simply do not know how many readmissions they have monthly and have been known to bend the truth even if they do and say “we had no readmissions,” so don’t rely on them to self-report.