How can I increase Hospice Referrals from Assisted Living Communities in 2023?

I was recently approached by an executive who owns assisted living facilities with affiliated hospice agencies under same brand. They inquired about how external hospice agencies manage to compete effectively and secure referrals over their in-house hospice agency. The executive's expectation was that their hospice agency would be the preferred choice, not out of obligation, but due to the delivery of high-quality care. I understood this perspective.

However, for those who currently work with or have experience with hospice agencies that do not own their own facilities, it's evident that the process can be challenging. It demands a significant amount of effort and communication between the hospice liaison, clinical operations team, and local staff at assisted living communities. Even after this coordination, the added frustration may arise when an in-house hospice agency submits a transfer request shortly after your admission.

Despite these challenges, there are choices to be made. One can either dwell on the negatives, ponder the fairness of the situation, or embrace a proactive stance and compete. I advocate choosing positivity and the determination to compete and succeed. Opportunities still exist in this landscape, and I've outlined a few strategies below that my top-performing colleagues have employed to increase their referrals from assisted living communities.

1. Respect Their Home:

• Understand that the assisted living community is the residents' home. Respect their protocols, routines, and regulations to maintain a harmonious relationship.

2. Regulatory Knowledge:

• Educate yourself about the regulations governing Residential Care Facilities for the Elderly (RCFE) in your state. Understanding the legal framework helps you provide safe care while staying compliant.

3. Build Strong Relationships:

• Initiate meetings with key personnel, such as the Executive Director, Wellness Director, med techs, and other staff, to document and understand the community's specific protocols. This includes policies related to the number of hospice beds allowed, check-in/check-out procedures, key contacts, medication restrictions, and weekend protocols. Strengthening the bond between your clinical team and the community is crucial.

4. Clear Communication:

• Ensure that all points of contact within the assisted living community are aware of who to call after hours for hospice-related matters. Enhance visibility with stickers, magnets, and signage in the medical room or patient rooms. Relying solely on contact information in the admission folder is insufficient.

5. Tailored Care:

• Increase Home Health Aide (HHA) visits as necessary and appropriate for the residents. Assess the clinical needs of the residents in each building and adjust the frequency of visits accordingly to provide the best care possible.

6. Adequate Supplies:

• Work closely with the assisted living community to ensure they have sufficient supplies for patients under your care. A well-stocked inventory is essential for the seamless delivery of hospice services.

7. Weekend Excellence:

• Differentiate your agency by offering high-quality services on weekends. Prioritize programs that include frequent communication and daily visits, especially on Fridays and for patients admitted during that time.

8. Be a Resource:

• Become a valuable healthcare resource for the assisted living staff. Don't just ask for hospice referrals; provide education and assistance related to other complementary providers such as private duty homecare, durable medical equipment (DME) suppliers, and visiting physicians who can serve as primary care providers for residents.

9. Collaborate for Holistic Care:

• Foster collaborations and partnerships that enhance the overall well-being of the residents. Explore opportunities to work with the assisted living community to address the full spectrum of residents' healthcare needs.

10. Continuous Improvement:

• Continuously assess and improve your services based on feedback from the assisted living community, residents, and your own team. Make adjustments to meet evolving needs and maintain a positive working relationship.

Remember that a proactive and cooperative approach, in addition to high-quality care, is key to increasing referrals from assisted living communities for your hospice agency. By respecting their autonomy, being knowledgeable about regulations, and offering tailored support, you can build strong, lasting relationships and secure more referrals.

-Joseph Allen