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Discharge planners are no different from anyone else, having feelings, worries, hopes, and dreams. To improve relations with discharge planners, you must first establish a connection with them. This means finding common ground to build a relationship based on shared interests and concerns or providing assistance that may benefit or improve their jobs. It is also crucial to look beyond your own needs and priorities, so to provide support and concern for their needs. 

Best Practices for Building Relationships With Discharge Planners

1. Accept Problematic Patients

One of the most effective ways for a facility to build trust with a discharge planner is to help him or her move a problematic patient—such as a patient suffering from drug addiction. While accepting such a patient is not in the immediate interests of your facility, this selfless act will likely result in future referrals. Thus, benefiting the facility after the initial burden. 

Meanwhile, accepting a problematic patient has several benefits such as: 

Discharge planner evaluating a patient in acute care.
One of the most effective ways for a facility to build trust with a discharge planner is to help him or her move a problematic patient.
  • Improving relations with discharge planners—The mere process of investigating a patient’s past medical history provides the perfect opportunity for liaisons to develop closer ties with discharge planners.
  • Establishing connections with physicians—Including the physician in charge of the patient makes this even more valuable for gaining future referrals because it cements the relationship between the facility and the staff of other healthcare providers. 
  • Perception management—The liaison and the physician are aware that when taking a problematic patient, the patient or their family may make unreasonable complaints to the hospital further down the line. To counter this, facilities should speak with the physician, explaining the situation to ensure there are no misunderstandings. 

Before taking on such a problematic patient, a liaison should: 

  • Ensure that their facility has the necessary tools, equipment, and staff to care for the patient.
  • Determine the past problematic behavior of the patient to establish how best they can counter this behavior.
  • Decide, along with leadership, whether the previous methods used are practical for your facility. 
  • Establish realistic expectations for the patient’s behavior and devise plans for dealing with such problems in the future. 

2. Be Authentic 

Approach case managers with your real (but professional) personality in order to allow them to get comfortable with you. Pretending to be someone you are not simply does not work. This is because any professional relationship is built on the foundation of trust and mutual benefit for all parties concerned. Over a sustained period of time and regular interactions, a relationship between a discharge planner and a liaison can develop into a meaningful yet beneficial relationship. 

Unfortunately, some liaisons mistakenly think they can shortcut the process and earn favor by offering gifts or pastries to physicians and case managers. This, though, has been a long overused method that has proven to be unsuccessful. Of course, passing out snacks may be a good icebreaker that then allows you to mention a particular area of specialization at which your facility excels. For instance, your facility may have an exceptional cardiologist.

Instead, when building a relationship with case managers, liaisons need to keep several things in mind. Firstly, they need to keep things professional. This means that nothing of monetary value can be offered, as not only is it highly unethical, but it can also result in conflicts of interest. This also includes offering “free tickets” to sporting events, concerts, or any other event.  

However, it is acceptable to arrange an impromptu lunch with a discharge planner, so long as each individual brings or purchases his or her own lunch. Similarly, a “lunch-and-learn” event can be organized, as it provides an opportunity for both parties to “learn” from each other. 

To qualify and arrange a “lunch and learn” event, it must include a common topic for discussion and an in-service sheet to establish that (even nominal) education is taking place. Of course, during these sessions, liaisons can take the opportunity to discuss specific patients or other relevant matters that can improve admissions. Of course, all patient matters discussed should not leave the hospital or be revealed to any unauthorized person.

3. Be Honest

A case manager may have a great relationship with a liaison, but at the end of the day, business is business. That means that, if a facility receives a bad rating or has been cited for abuse, facilities cannot expect to automatically get referrals on account of a friendship with the discharge planner.

Liaisons should always remember that physicians and discharge planners will want the best care outcomes for their patients. Hence, they will typically consult with the family of the patient and check the CMS 5-star rating of the facility. The facility should be ready to answer questions from family members, and they should do their best to ensure they have the highest CMS 5-star rating they can get.

Should the discharge planner ask about the cause of a low CMS 5-star rating, the best course of action for liaisons is to be fully transparent and to offer an explanation, citing low staff numbers or clarifying that the survey tags are from a previous year and will soon disappear. However, if the facility has no good reason, the liaison must simply own up to the flaws of his or her facility. If your facility was cited for abuse, ensure that it was an isolated incident that was addressed and explain to the case manager that the employee was terminated. Honesty is the best policy.

Meanwhile, if a facility is unable to admit a patient that has been referred to them—on account of the patient being too troublesome, abusive, or possessing a criminal record—the liaison should immediately voice their concerns. Thus, giving an explanation to why they will not admit the patient while ensuring that the relationship is untainted, and neither party wastes each other’s valuable time. 

4. Be Persistent

It is also helpful to stay present in the case manager’s mind with regular contact every couple of days. Liaisons can take this opportunity to ask how they are feeling while improving relations by talking about shared hobbies or interests. However, be mindful that case managers have busy schedules. Therefore, it is best to avoid them during inconvenient times, for instance, when they have busy workloads or are spending quality time with family.

To do this, you will need to get their personal number. One way to do this is to share your personal number with them and let them know that you are available should they need you. If you are unsure about how best to exchange personal numbers, try casually asking them to text you or vice versa, something along the lines of: “I know you may need to reach me at any point in the day. You’ll be able to get ahold of me faster if you text me. Here’s my number. Can I get yours?” 

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How to Become a Favorite Among Physicians

Physicians and surgeons often have preferred facilities to which they send residents. The question is, how do they arrive at these preferences? 

These medical professionals tend to have worked in a hospital for a long time and developed relationships with particular liaisons and long-term care facilities in the process. That means they will have established trust with the people with whom they have interacted and found reliable. To take referrals from those other facilities, you, too, will have to earn their trust

While name recognition is a great advantage, you can still gain the trust of physicians by demonstrating the outstanding outcomes at your facility. If you can build a strong face for your organization by emphasizing that it has a reputation for excellent care, great relationships with the families of residents, a reduced rate of infections, and a low rate of rehospitalization.

Consider the Physician’s Perspective 

Physicians want to know that their patients will be given adequate care. They are also concerned about the likelihood of rehospitalization. As a liaison, it is up to you to assuage their fears. If you can use past patient referrals to support the idea that readmissions and family complaints are unlikely to occur, you are more likely to get regular referrals from physicians and surgeons.

Physician caring for a patient
Physicians tend to be concerned about the likelihood of rehospitalization. As a liaison, it is up to you to assuage their fears.

To convince a physician to stop referring patients to a competitor and send them to yours, try: 

  • Visiting their office
  • Producing handouts with pertinent stats and information
  • Attending hospital luncheons and networking opportunities
  • Conveying information through the case manager

It is crucial to remember that building relationships with physicians cannot be rushed. You must be persistent in pursuing them until you eventually find a convenient time to chat and present your case. Do not be surprised if you initially receive a referral to your facility as a “test” from the physician to see whether your facility can live up to their expectations. In such cases, do everything you can to ensure the best care for your patients. And ensure that their families are equally satisfied with your facility’s care.

It is always worth connecting with the medical director of a hospital, as he or she has a lot of sway. If a strong relationship built on trust is established, you and your facility will have a steady stream of referrals. 

When communicating with physicians or medical directors, you will also want to emphasize: 

  • The proximity of your facility
  • Rehospitalization rates
  • Strong areas of specialization, like cardiology or wound care
  • Quality measures
  • Superior CMS 5-star ratings 
  • Low readmission rates
  • A lack of complaints
  • A high number of family referrals

Building Relationships With Home Health Agencies

Hospitals, of course, are not your only source of referrals. That is why it is also important to build connections with home health agencies and their case managers. The process, though, is somewhat different from building relationships with hospital case managers. 

Home health agencies and long-term care providers need each other and function as equals. Home health agencies can send patients to nursing homes and SNFs,  and long-term care facilities can discharge residents and refer them to a home health agency. So a liaison must look to establish a partnership of mutual benefit for both sides

How to Help Home Health Agencies

Home health caregiver checking up on an elderly patient.
Home health agencies and long-term care providers need each other and function as equals.
  • Send them referrals: The biggest service you can provide home health agencies is sending referrals their way, meaning, discharging residents to their agencies. This will resonate with them and result in them remembering your facility when they need to send someone from home health to a skilled nursing facility. 
  • Help convince patients to get the care they need: Some patients in home health who now require long-term care will resist the transition. The liaison can speak with the families of these patients and invite them to visit the facility along with the home health case manager. This will reassure them that their loved ones will receive the care they need in a nursing home.
  • Reduce rehospitalization rates: Like hospitals, home health care agencies strive to avoid rehospitalization. Therefore, a liaison should reach out to home health agencies and claim patients who are having problems with caring for themselves at home to prevent them from needing acute care again. Liaisons should begin by using already-existing relationships; find out which home health agency your facility has dealt with in the past, and begin a discussion with their case managers.
  • Be the middle man: a liaison can act as a middle man between hospitals and home health. A patient may be discharged from the hospital, undergo therapy, then be moved to home health before beginning to decline again. Instead of allowing them to decline to the point of rehospitalization, home health agencies can contact you to prevent rehospitalization. Talk to the home health case manager, and should any of their patients need specialized care, let them send the person to your SNF instead of back to the hospital so they can the around-the-clock care that they need. This is beneficial for them, as they can build rapport with hospitals on account of not sending patients back to them. 

By claiming patients that will eventually end up in the hospital should they remain at home, you are allowing the agencies to continue to receive from hospitals patients who actually require no more than home health. And in the process of helping the agencies avoid rehospitalization, you are also building your SNF’s referral sources, helping census numbers, and developing a relationship that will be beneficial in the future. 

It goes without saying that as a liaison, you should verify that your facility can provide 24-hour specialized care or therapy and have the equipment the patient needs before accepting them at your facility.

Building Relationships With Hospice Agencies

Hospice patients are different from other patients that are admitted into long-term care in that they typically do not have long to live, and their code status is more likely to be DNR. Family of hospice patients usually do not want to deal with the death of a loved one at home. Other times, a hospice patient is temporarily brought to a long-term care facility because the family will be out of town and cannot care for him or her during that period. In these situations, a hospice agency will contact a long-term care facility and request that the individual be given a respite stay

A long-term care facility can be a place for families to ensure their loved ones receive the best care they need during their final days. For many, hearing that a loved one is “active,” or, in the process of dying, will be overwhelming. That is why it is crucial to help them get those seniors into long-term care as quickly as possible. 

Hospice patients will typically stay at your facility for anywhere from a few days to a few weeks and require more attention than others. The realistic goal is not for hospice patients to get better but rather for them to spend their remaining days in a comfortable environment with dignity. 

While they are not ideal cases, liaisons should not overlook hospice referrals but rather build strong relationships with hospice agencies to receive regular referrals from them. When family members learn that a loved one is now in the active stage of dying, it may be too much for them to handle. They often look to move them immediately. You can help out a hospice agency by making that happen quickly. 

The Benefits of Accepting Hospice Patients

Patient in hospice care.
While they are not ideal cases, liaisons should not overlook hospice referrals but rather build strong relationships with hospice agencies.

While going through the admissions process for a short-term patient is a bit of a hassle, it can certainly pay off in the long run. Some of the reasons facilities will want to accept hospice patients from agencies that are between a rock and a hard place are that: 

  • They help buffer census numbers. Yes, they may only be there for days or weeks, but a regular flow of them can help you keep your beds occupied. 
  • Facilities are reimbursed at a higher rate for hospice patients, often about twice as much as they are reimbursed for non-hospice patients.
  • Some, in fact, may end up being your residents for a while. Not all hospice patients will only be at your facility for a short time. Rather, you will find that some live with a terminal diagnosis for many months or even a couple of years. If they qualify for Medicaid, you can secure reimbursement for them similar to other residents. 

What to Expect

Before accepting a hospice patient, you will want to get in contact with nurses who have previously cared for him or her and understand their demands. Ensure your facility can provide the care the patient may need, and make sure all arrangements for transportation are finalized. You may need to involve the SNF administrator and other relevant staff.

Traits of the Liaison That Gets Referrals

So what should you look for in a liaison if you are trying to increase your census numbers? Obviously, you want an individual with the appropriate background. But you should also strive to find someone that understands people and is good at staying on task. Here are some of the prominent traits you should pursue: 

  • A clinical background: As we mentioned, a clinical background makes it easier to forge relationships and understand the medical terminology used. Ideally, a liaison should have some previous medical experience as a CNA, RNA or similar profession. The reason for this is, if one is just a marketer, they cannot understand the nuances of conversations about patients nor can they relate to the problems that case managers and physicians face. Meanwhile, if one has been on the clinical side, building relationships is easier, as you and the case manager can share “war stories.”
  • Interpersonal relationship skills: Ideally, the liaison will have these upon getting hired. However, if one does not, one should be willing to improve in that regard. While one must be authentic, that does not mean he or she should embrace asocial behavior and refuse to change. Rather, the liaison should demonstrate that he or she is working toward developing social skills, whether by reading self-help books or using other online resources.
  • Organization: Following up on potential referrals, keeping meeting times, and properly keeping track of relationships (wishing someone a happy birthday) are a must for liaisons.  
  • Independence: One should be able to operate effectively without direct supervision.
  • Efficiency: As one organizes meetings and reaches out to case managers and physicians, they should be able to make the most of the little time they have throughout the day. Also, as physicians may not always be free to talk to, a liaison should be able to make the most of the short meetings they do get.
  • A good reputation: People talk. The best liaisons have built a reputation for being friendly, trustworthy, easy to talk to, and dependable. Adding someone like that to your team will give you a great advantage. 

Summary

Improving census numbers is a team effort that requires consistent and honest evaluations of every aspect of a facility. That is why it is important to have the right people in the right places. Tour guides should be prepared to answer questions and know how to connect with visiting families. Liaisons must invest time into connecting with discharge planners, physicians, and other agencies. Ultimately, your team must be aware of and responsive to the concerns of decision-makers. When an organization learns to think like potential residents and those tasked with placing them in the best possible environment, it will likely see a rise in referrals and census. 

For more on recent trends in long term care, read our blog and subscribe to the LTC Heroes podcast.

Elijah Oling Wanga