Frequently Asked Questions
Q: What is the skilled nursing facility "SNF" benefit?
A: For seniors and disabled individuals, CMS allows up to 100 days of skilled nursing treatment in a nursing facility setting after an episode of illness that requires continued care outside the acute hospital. Medicare beneficiaries must still have a 3 day qualifying stay at an acute hospital in order to gain admission to a SNF for further care and therapies. Managed Medicare beneficiaries (HMO) patients can be admitted directly from their doctor’s office, their assisted living or the ER to a SNF and receive skilled benefits without ever having spent time in a hospital. Typically, patients receive physical, occupational and speech therapy, IV antibiotics or fluids or wound care on a daily basis.
Q: Why should you partner with GeriNet to be your SNF-ologists or SNF hospitalists?
A: We provide excellent care to both Medicare and HMO patients. The ALOS average length of stay for a Medicare beneficiary in a skilled nursing facility across the US is 30 days. At GeriNet, our ALOS for our HMO patients is 11 days. As experts in managed Medicare, GeriNet professionals excel in reducing SNF beddays and return to acute (RTA) for our clients at risk with proven proactive strategies. These strategies include:
- Personalized communication with all new admissions to determine prior level of function PLOF, goals and Length of Stay LOS expectations.
- Excellent medical management of geriatric syndromes- chronic and acute pain, dementia, pressure ulcers prevention and treatment, depression, cachexia.
- Discussion of Code and transfer status.
- Regular Communication with therapists, nurses and facility case managers to expedite Last Covered Day LCD.
- Frequent visits on skilled patients- typically 2 or more times a week depending on medical necessity.
- Most patients seen within 24 hours of admission.
- Weekly Conference calls if requested and regular JOC meetings with client Medical directors, case managers for ongoing Performance Improvement.
- Specific and focused documentation in SNF medical record to support issuance of LCD to reduce overturn of LCD by appeals.
- Physician to physician calls regarding ER transfers or direct hospital admission to preferred plan hospital as possible.
- Feed back to medical groups about SNF performance, capabilities and weaknesses in managing skilled patients.
- Discharge Summaries sent to PCPs, and others by request at time of discharge to lower level of care.
- RAF ICD-9 codes submitted to medical groups from GeriNet providers.
- Custodial residents seen monthly and as medically necessary to prevent avoidable RTA and reduce readmissions/K
- Timely initiation of comfort care and referral to Hospice.
Q: Does GeriNet provide acute hospitalist services also?
A: Yes! GeriNet provides acute hospitalist services at Harmon Medical and Rehabilitation Center in Las Vegas Nevada since March 2009 for UnitedHealthcare and SouthWest Medical Associates. For further information, contact Mirit Avram MD, Hospitalist Program Director at (702) 622-3192
Q: What nursing facilities do GeriNet physicians cover?
A: GeriNet medical staff currently round in over 360 nursing facilities in 5 southern California and Las Vegas Nevada. Facilities can be added per contract requirements.