Don’t take competition from home healthcare lightly

There are a few trends right now threatening both facilities’ skilled and overall census. One of the most significant trends: With increasing frequency, patients are choosing to go home with home care despite a 3-day qualifying stay at a skilled nursing facility.

The average person has a negative perception about SNFs, which is one of the reasons why patients are choosing to go home with home care. With hospitals honoring patient choice, case managers are making every effort to ensure their patients can go home. Other hospital team members are in on the plan—for example, PT and OTs positively encourage patients to go home with home care during therapy sessions.

Another reason is that some physicians, especially orthopedic surgeons, don’t like SNFs because of a previous negative experience. These negative experiences include poor communication, failing to follow MD orders and acquired infections.

Here are some strategies—all of which involve face-to-face interactions—that I encourage you to employ to turn the tide back in your favor:

Meet with families during the admissions process and discuss why they’ve chosen to go home with home care. (Of course, you can only do this if you’ve received the referral from the hospital.) Dispel their fear about nursing homes with a focus on your rehabilitation services. Compare the amount of therapy a patient receives at home (1 hour per day, 3 days per week) to the amount they receive in your facility (up to 2 hours per day, 7 days per week). Finally, tell the patient that your services are a “benefit” they will lose if they go home with home care; however, they will not lose their home care benefit if they come to you first.

Hold in-services with rehab departments to educate therapy staff about your strengths in rehabilitation with a focus on the amount of therapy your patients receive. Increases in referrals usually follow after this in-service.

Meet with case management, especially if you have experience admitting patients who have had a 3-day qualifying stay but went home instead. Use this data to demonstrate the risk the hospital is facing with potential re-admits.

Meet with physicians who don’t like nursing homes and demonstrate that their negative experiences are not what they will experience if they send their patients to your facility. Also, focus on your ability to meet their expectations (especially for communication and orders). Also, send a physical or occupational therapist with your patients when they return to their MD for post-surgical visits. This tactic has been used to great results.

Luke Fannon is the Founder and Principal at Premier Coaching and Training, Unionville, Pennsylvania. PCT provides long-term and healthcare sales and marketing training, admissions and marketing team coaching and other strategic consulting services. For more information, visit

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