Benefits of Telemedicine for Skilled Nursing Facilities

Reduce readmissions, increase provider efficiency, and cut costs with Telehealth in your skilled nursing facility

Healthcare delivery around the world has forever changed due to the COVID-19 pandemic.  This global pandemic is having the largest impact on our seniors, especially those who reside within a skilled nursing facility (SNF). As COVID-19 spread, stay at home orders and social distancing restrictions became widespread, and access to care was restricted. In a matter of weeks, patients and residents residing in SNFs were unable to be seen by their physicians or loved ones due to visitation restrictions. Furthermore, sending patients to the hospital was challenging given hospitals being overwhelmed with COVID-19 patients. The use of Telehealth became one of the only options to deliver healthcare and limit personal contact to prevent further spread of the virus.

The burden on the staff and residents of long-term care facilities, including nursing homes and skilled nursing facilities, has increased significantly around the country during the coronavirus pandemic. Hospitals in many locations are looking to discharge more patients to these already filled facilities, and the COVID-19 virus is severely impacting the nursing home population in particular because their generally older and sicker residents are much more likely to die or become severely ill from the virus than people in the general population. In addition, they’re having trouble sourcing PPE and social distancing is difficult or impossible in many facilities.

The Centers for Medicare and Medicaid Services (CMS) has responded to feedback from industry stakeholders by using the 1135 waiver authorities granted in the Coronavirus Preparedness and Response Appropriations Act to implement several policy changes enabling practitioners to provide remote virtual services to skilled nursing facilities and to remotely supervise on-site providers. In addition, CMS is encouraging facilities to adopt remote solutions for visitors to nursing home residents. In its March 13 letter on infection control and prevention of COVID-19 in nursing homes, CMS stated: “In lieu of visits, facilities should consider…offering alternative means of communication for people who would otherwise visit, such as virtual communications (phone, video-communication, etc.” This has created a new opportunity for the growth of remote or virtual care solutions for long term care facilities and the practitioners who serve them.

Empower Your Nursing Staff

Put your medical director in multiple clinics at once with provider to provider Telehealth consults. Empower your nursing staff to avoid unnecessary readmissions and transfers by escalating concerning cases directly to specialists with the push of a button.

Reduce Readmissions

Nurses and medical aides can escalate concerning cases to physicians via video—especially during off-hours—reducing transfers of fragile patients to emergency services.

Multiway Consultations

Patients and providers can invite caregivers and specialists to join the visit, improving care coordination.

Get Full Medicare Reimbursement in the Skilled Nursing Facility

Every skilled nursing facility must abide by rules set by Medicare, particularly when it comes to Potentially Avoidable Hospitalizations, or PAHs. In fact, Medicare will soon be changing its reimbursement policy so that if a patient is readmitted to a hospital after a short stay in skilled nursing, the facility is penalized with less reimbursement money through the Medicare program. These changes don’t go into effect until 2019, but skilled nursing facilities are already receiving feedback reports on their performance. More and more, the skilled nursing facility is discovering that telemedicine provides a viable solution for monitoring, assessing, evaluating, and diagnosing patients on site without transferring them out of the facility for care – thus avoiding getting dinged by Medicare in the process.

Telemedicine a Solution in Medicare Readmissions Reduction Program

The Centers for Medicare & Medicaid Services began its Readmissions Reduction Program under the Affordable Care Act. Under the program, if a patient is readmitted to a hospital within 30 days of discharge, then the facility sees an impact on its Medicare claims by way of reduced Medicare reimbursements. The purpose of the program is to improve the outcomes of patients residing in skilled nursing facilities by achieving a low return-to-hospital rate. Lack of after-hours and weekend staffing plays a big part in readmissions, but telemedicine is helping to close the gap in care that is prevalent throughout the industry.

Telemedicine for the Skilled Nursing Facility

From Medicare’s viewpoint, PAHs not only cost the government money, but they also result in exposure of already vulnerable nursing home patients to outside health risks and frustration. Most patient readmissions occur when there is no physician on call, often leaving support staff with little choice but to transport patients out of the facility for treatment for acute illnesses and other conditions.

With two-way video conferencing between a Telehealth provider and the patient and staff, readmissions and hospitalizations can be minimized. This type of consultation allows the Telehealth doctor to communicate directly with the patient, face to face, assessing the patient’s condition, making a diagnosis, and ordering the proper treatment. This saves the nursing facility from the penalty of a readmission while allowing the patient to remain in place without the hassle of being transported to an ER or clinic.

Using telemedicine, staff can work with the consulting physician via a telemedicine cart, which includes a high-quality web cam that can zoom in on specific areas of the patient’s body if needed to make a definitive diagnosis remotely without the doctor being present at the facility. From evaluating pressure wounds to determining the source of a mysterious rash, doctors using this equipment provide high-quality assessments as if they were doing their rounds in person.

Telemedicine Benefits for Skilled Nursing Facility Patients

Patients stand to reap several benefits from telemedicine in a skilled nursing facility. Patients:

• Do not have to leave the facility needlessly and be inconvenienced with unwarranted trips to the ER.
• Experience fewer readmissions.
• Avoid outside health risks.
• Can seek evaluation quickly when a condition arises.
• May be evaluated by a physician with whom they are familiar and that they trust.
• Can be seen 24 hours a day, every day of the year, from the comfort of their own rooms in the facility.

Implementing Telemedicine in Skilled Nursing Facilities

While not designed to replace the face-to-face healthcare that skilled-nursing patients require, telemedicine does fill a huge void left by understaffed facilities where the employment of a round-the-clock physician is not feasible.

With the October 2016 risk-adjusted PAH rates in effect, skilled nursing facilities have begun migrating to pay-for-performance. Since Medicare reimbursement for skilled nursing facilities is now based partially on each facility’s rate of readmission, telemedicine is becoming more and more vital for all facilities looking to leverage technology to not only improve patient outcomes, but reduce penalties that affect their overall bottom line.

Improved Patient Care

Convenience
Virtual visits make healthcare services more convenient for patients. With telemedicine, a patient seeking clinical health support from a physician can get treatment without leaving the facility. Greater convenience also leads to more routine treatment and better outcomes.

Continuity of Care
With the ease of scheduling and attending appointments from home, more routine appointments can be scheduled as needed with preferred caregivers. Fewer missed appointments mean that patients are more likely to achieve the goals of their treatment program through greater adherence to evidence-based treatment.

Enhanced Productivity

Operational Efficiencies
The use of virtual visits can allow a provider organization to leverage various levels of clinicians to engage the patient to address different needs. The convenience of an online appointment can allow a patient to secure both therapy and medication management from the convenience of their home.

Clinic Throughput
Virtual visits, whether scheduled for the patient or by themselves, can eliminate the inconvenience of travel to see a provider, missed appointments and/or patients simply not seeking care. In this way, online visits can ensure clinicians have highly productive days.

Support Clients Between Scheduled Visits
Just like other areas of medicine, patients in Skilled Nursing Facilities can have acute episodes needing timely intervention. Telemedicine can enhance supportive care by providing greater access to the appropriate clinicians.

Extend Service Reach
Providers who offer services virtually can expand their reach to new clients beyond their local area, or secure specialty services to better meet a patient’s needs.

Timely Assessment
When patients visit the ED with a health complaint, timely evaluation is important. With prompt assessment, patient management burdens are reduced, and treatment decisions can be made more rapidly.

The PrimaHealth Skilled Nursing Facilities Telehealth Solution

PrimaHealth’s Telehealth Virtual Care platform offers healthcare professionals a complete virtual clinic to easily launch online services. Our industry-leading digital exam room provides all the tools to engage patients in one click, and document the encounter. With advanced capabilities such as multi-party visits, high-resolution screen sharing, and file transfer, the PrimaHealth Telehealth software platform allows healthcare providers to deliver convenient and timely care to their patients wherever and whenever they need it – just as if they were in the clinic exam room.

Key features of the PrimaHealth Telehealth platform for Skilled Nursing Facilities  include:

Powerful rules engine for intelligent workflow, with customized rules that can control patient registration and ensure patients are routed to the appropriate provider (e.g. psychiatrist, psychologist, social worker) who is licensed to comply with treatment needs and meet jurisdiction requirements.

Enterprise-level dynamic scheduling system, enabling appointment scheduling by providers, administrative staff, or directly by patients themselves; true on-demand encounters can be facilitated via a unified patient queue vs. the antiquated, one-dimensional booking-based approach used by others.

High-definition video for virtual digital exams that can support multi-participant and/or clinician-to-clinician sessions, enabling timely care and decision-making. This high-quality video experience can also improve intimacy with the patient to enhance the clinical encounter.

Market-leading compliance adherence and security layers including HIPAA, HITECH , GDPR and COPPA-compliant software. Combined with complete logging of all transactions, with data available for extract to meet audit requirements.

Robust set of API and SDK libraries to provide integration with third-party systems or development of complementary applications.

Virtual visits can be an ideal complement to traditional care or can provide access to care for many patients currently not treated. PrimaHealth’s Telehealth platform can support a variety of service lines across a multi-specialty care group, and bring a new level of convenience to patients, increasing the likelihood of treatment plan success.