Is your care center, in the words of famed chef, Emeril Lagasse, “Ready to take it up a notch?” If you have available space, clinically sophisticated staff and available marketplace, a 24-Hour Short-Stay Recovery Program may be right for your organization. They key is doing it RIGHT!
Careful planning is necessary to develop a successful 24-Hour Short-Stay Recovery Program. Issues that need to be addressed when considering such a program include:
- Physical plant and environment
- Clinical skills of staff
- A marketplace that has a significant number of outpatient procedures performed on a daily basis
- Local demographics that include a large percentage of the population that is under 65 years old
The most critical component in determining whether or not such a program can be supported at your care center is whether there is a market for this specific program. A younger population is most normally seen in this setting since insurance payors have greater flexibility in paying for care in alternative settings. Medicare does not have a benefit for this type of program given their minimum stay admission criteria.
Critical program elements to assure the success of a 24-Hour Short-Stay Recovery Program include:
- A separate unit with outside access, including separate dining and lounge areas.
- Distinctly defined admission and discharge criteria.
- Dedicated staff, all of whom have demonstrated excellent clinical skills.
- Contracts with managed care organizations willing to flex benefits (i.e., in lieu of hospital day, etc.) to cover the costs of care in the setting.
- Contracts with local surgical groups, utilizing a portion of their global fee for payment in the setting.
- Contracts with any “at-risk” providers (those receiving a capitated fee).
The 24-Hour Short-Stay Recovery Program is designed to provide patients, not residents, with additional recovery time following an outpatient procedure. This setting would also be appropriate if an individual requires observation following an emergency room stay, day treatment or ambulatory procedure while in a hospital setting.
The following procedures would be appropriate for follow-up care in a 24-Hour Short-Stay Recovery Program: eye surgery, various gastrointestinal surgeries, orthopedic surgery (joint), ENT procedures, plastic surgery, etc. It is critical that the facility staff be well versed in post-surgical care.
Other program considerations include:
- A shortened admission process with pre-approved physician orders. This will expedite the admission and eliminate any delays.
- Providing patients with an enhanced recovery environment, including private rooms with electric beds, lounge chairs for family members to spend the night, TVs, DVD/CD player, library and complementary care including massage and other modalities.
- Open meal times with flexible food choices.
Marketing the program to both members of the local community and medical professionals is critical to developing successful referral relationships. Understanding the clinical services being provided to the range of patients and articulating those in a succinct and clinically sophisticated manner will encourage physician referrals. Community members need to see a clear distinction between the regular nursing home and the services and care provided to the patients in this setting. If a distinction is not made, there may be strong resistance from the younger individual admitted for an additional recovery period. Remember, with the right staff, equipment, supplies and physician support, an individual can be successfully treated for most conditions in any setting.
You just need to “take it up another notch!”