For older adults managing chronic health conditions or younger people managing serious illnesses or injuries, post-acute care is crucial. Post-acute care, such as physical and occupational therapy, can reduce a patient’s chances of being readmitted to the hospital.
As a provider, you’re likely juggling clients in each of these facilities, as well as home health or hospice. You may think these terms are interchangeable, but that’s not always the case. It’s important to properly classify post-acute care so your patients get the right treatment plan for their specific needs.
Medicare and other insurance providers also have rules about PAC coverage. These rules cover required documentation, the maximum number of visits, and other crucial information. Failing to properly classify a patient could lead to claim denials, causing your patient more stress.
What Counts as Post-Acute Care?
Learn the key points with this brief guide to the post-acute care definition.
SNF vs. LTC
Understanding PAC starts by knowing the difference between SNF vs. LTC. Skilled nursing facilities offer a higher level of care than long-term care facilities. At an SNF, patients are treated by trained registered nurses under a doctor’s supervision.
LTC patients generally receive care from licensed nurses or nurse’s aids under a registered nurse’s supervision. SNFs provide a similar level of care to a hospital. In these facilities, you’re likely working with patients managing multiple medical conditions or treating them closely after surgery.
LTC patients often need help with daily tasks such as getting dressed, bathing, or eating.
Medicare Definitions
Medicare considers a facility to be an SNF if your patients are getting daily skilled care, such as medication management or physical therapy. It only covers these services if the patient had a qualifying inpatient hospital stay for at least three days in a row. The agency classifies LTC as medical and non-medical services for people with chronic illnesses or disabilities.
Why Classification Matters
People who need PAC are at risk of illness or injury because they’ve recently had surgery. For older patients with comorbidities, such as heart disease or diabetes, PAC can greatly improve their outcomes. This requires coordinated care with a team of specialists.
When registered nurses, occupational therapists, physical therapists, and other therapists know a patient is receiving PAC, they can create a specialized treatment plan based on a patient’s condition and their risk level.
The Challenge: Fragmented Documentation Systems
Smooth transitional care depends on the right care communication tools. If you’re a provider at LTCs, SNFs, and other facilities, you know that each has its own documentation style and workflows. This lack of continuity can put patients at risk.
Inaccurate or incomplete information in a patient’s medical records can harm patients. You might treat them with a drug that interacts badly with something they were already taking. Or you might miss critical symptoms because someone else on the care team failed to note a previous occurrence.
For example, your patient may have complained of intense headaches or dizziness to another specialist. If you don’t know, you might misread a different symptom that could signal an impending stroke.
Unifying the Document Strategy
PAC requires care coordination tools and accurate documentation. Coordinated healthcare documentation workflows give each member of a patient’s care team the full picture of their health. As a physical therapist, you can see a patient’s full medical history and note any previous conditions or surgeries that would impact their ability to follow your treatment plan.
Each member of the care team can focus on their treatments instead of searching for documentation and missing data by using a centralized documentation platform. Using one that is specifically made for PAC allows everyone on the team to capture the same data and attach notes and other forms to a patient’s electronic health record (EHR).
With a single solution, each caregiver knows they have the latest data on hand. It’s also important for billing and auditing purposes.
How WorldView Supports the Whole Continuum
WorldView’s enterprise content management (ECM) solution offers centralized access to all important patient health records. Everyone working in an SNF, home health aides, and hospice team members can effectively coordinate treatment plans and transitional care using the latest data.
Each specialist can access referrals, patient notes, and other important information to guide the care plan. Our solutions are scalable in any post-acute environment for standardized data management.
Conclusion: Document Control Is a Strategic Asset
Knowing your care categories will help you effectively treat patients based on their unique needs. It will also simplify the billing process, since you know what data to capture and transmit. Properly classifying a patient receiving post-acute care also lets you know what documentation to look for in your referral.
For example, if you don’t see a qualifying hospital stay, you can either send the referral back or determine if you need to use another Medicare classification.
Unifying your document management plan also enhances post-acute care with seamless coordination. You and your team of specialists can help patients recover instead of chasing missing data or trying to treat a patient with an incomplete picture.
Contact us today to learn how to standardize documentation across care settings.
