Many hospitals are having difficulty discharging COVID-19 patients to post-acute providers. To avoid these bottlenecks, hospitals should work to identify post-acute providers that are accepting or are currently caring for COVID-19 patients. Within CarePort for example, post-acute providers are updating their capacity to accept COVID-19 patients on a daily basis, allowing case managers to filter down to only those providers that can accept COVID-19 patients.

When should a COVID-19 patient be transferred to post-acute? What care protocols should the nursing home or home health agency follow? What happens if a COVID-19 patient decompensates in a post-acute setting? Hospitals are creating transitions of care protocols for COVID-19 patients to ensure a successful discharge. As part of that, hospital customers are building upon their post-acute partnerships and working with post-acute providers on discharge and placement criteria, post-acute care plans, and communication protocols. For example, CarePort is working with its hospital clients to notify post-acute providers in their immediate geographic regions regarding COVID-19 protocols, best practices and the status of patients undergoing testing to reduce time spent by individuals completing this manually. CarePort is also providing clients with a COVID-19 assessment created by one of our client partners for patients referred to nursing homes. Nursing homes can use this information to easily identify if they are able to accept the patient.

Hospitals may be aware of COVID-19 diagnoses at their own facilities, but patients though often seek care at outside hospitals, and even across state lines. Hospitals in a region are working together to share information on COVID-19 patients who may be seeking care from multiple health systems. For example, hospitals are activating real-time notifications for newly diagnosed COVID-19 patients. Hospitals are using CarePort to automatically alert providers who may have had an encounter with the patient in an ED or nursing home prior to diagnosis. Real-time alerts are also being sent to the primary care physician so that they can help with follow-up care.

Many hospitals and nursing homes at this time are restricting visitor access. As part of the conditions of participation for discharge planning, hospitals must share post-acute care options with patients and help them select a post-acute provider. Without the ability to tour facilities or a family member at the hospital to help, hospitals must adapt their discharge planning processes. For example, hospitals are using CarePort to share nursing home options with families via text message or email. Family members, who otherwise would be on-site, can see an interactive guide that includes virtual tours and pictures and help their loved ones select the right post-acute provider.