Referral & Admission ProcessConsolo | Referral & Admission Process – November 2013 7 | P a g e...

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Consolo | Referral & Admission Process – November 2013 1 | P a g e

Referral & Admission Process

Entering a New Referral

Select New Referral under the Patients menu. Complete each section as necessary. Blue

shaded fields are required.

Referral Information Section

Complete all fields as necessary. Blue-shaded fields are required.

Effective Datetime – When was this referral received? Defaults to ‘Now’. Click in field to

change the date and/or time.

Referral Office – Which of your offices received this referral? Choose from the list.

Referral Source – Who referred the patient to your hospice? Begin typing in the field and

Consolo will find matches from your index of referral sources (Services menu/Family &

Referral Sources). Select the appropriate match.

Community Liaison – Optional. Which of your employees generated this referral? Begin

typing a name and Consolo will find matches from your list of community liaisons (Admin

menu/Users). In order to be selected here, the employee must have Community Liaison

as one of their roles.

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Referral Obtained By Notes – Text field for commentary related to the acquisition of this

referral.

Facility – Is the patient in a facility at the time of referral? If yes, start typing a name and

Consolo will find matches from your list of facilities (Services menu/ Facilities).

Planned Service Location – Where will hospice services be provided, if the patient is

admitted? Leave blank if the patient is at home, and home is the planned service

location.

Physician – Is there a physician associated with this referral? This may or may not be

the patient’s attending physician. For example, perhaps a hospital physician suggested

hospice to the hospital discharge planner, who in turn called hospice. The hospital

physician will have no further involvement once the patient is discharged with hospice.

The hospital discharge planner is the referral source; the hospital physician could be

listed here for future reference. Begin typing a name, and Consolo will look for matches

from your list of physicians (Services menu/Physicians).

Referral Status – (Optional) What is the status of this referral? Choose the appropriate

option:

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General Patient Details Section

Complete all fields as necessary. Blue shaded fields are required.

Note: All patient names should be entered in same capitalization format, either “First

Last” or FIRST LAST”.

First Name – Patient’s first name. Should be exactly as it appears on their Medicare/

insurance card.

Middle Name – Optional.

Last Name – Patient’s last name. Should be exactly as it appears on their Medicare/

insurance card.

Suffix – Text field for suffix, if any.

Nickname – Does the patient have a preferred alternative name that may be used to

address them?

Date of Birth – Patient’s birthdate. Use the date helper, or manually type in dates in

MM/DD/YYYY format.

HIPAA Specific Instructions. Are there any privacy or disclosure related instructions?

Text entered in this field creates an Alert on the patient’s homepage.

Home Phone – Enter digits only, like 6165551212.

Mobile Phone - Enter digits only, like 6165551212. If no home phone is present, mobile

phone will display on patient’s face sheet.

SSN – Patient’s Social Security Number. Required. Enter digits only like, 123456789.

Religion – Optional. Select from the list.

Marital status – Optional. Select from the list.

Languages Spoken. Defaults to English. Text field for additional languages.

Spouse Name – Text field to capture spouse name. If involved in patient care, spouse

must be separately entered as a Contact & Family Member, on the patient’s homepage.

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Race – Optional. Select the appropriate race/ethnicity from the list.

Gender – Required. Note: Medicare only acknowledges “Male” and “Female”.

Retirement Dates – Use if the patient is not yet, but will be in the future, eligible for

Medicare.

Home & Mailing Address Sections

Complete all fields as necessary. Blue shaded fields are required. Mailing address defaults

to Home address, unless the default box (circled) is un-checked. If Home and Mailing

addresses are the same, the address only needs to be entered once.

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Patient Care Directives & Military Service Information Sections

Code Status – Optional. This is the only place in Consolo where code status is recorded.

From here it flows to other locations in the patient’s record.

Code Status Note – Text field for elaborating or clarifying the patient’s code status.

Disaster Acuity – Optional. How urgently would the patient need attention in the event of

a disaster that interrupted your normal business operations?

Disaster Priority Tree – Optional. Text field for elaborating on disaster plans.

Living Will – Does the patient have a living will? Text field to elaborate.

DPA – Does the patient have a Durable Power of Attorney? Text field to elaborate.

Designated Surrogate – Does the patient have a designated surrogate decision maker?

Text field to elaborate.

NOTE: Different states use different terminology to identify living wills, health care

powers of attorney, financial powers of attorney, etc. You should have a policy that

clarifies which field is for tracking which item.

Veteran – Optional. Text field to elaborate.

Military Service Branch – Optional. Select from the list.

Military Service Era – Optional. Select from the list.

Military Service Rank/Pay Grade – Optional. Text field to clarify.

Enrolled in VA? – Optional. Check if “yes”.

When ready, “Create” the referral.

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Patient Homepage

Once the referral is created (saved), you are taken to the patient’s homepage, which looks like

this.

See the Patient Homepage reference document for a full orientation to the patient’s homepage.

At the top left of the screen, highlighted in orange, is the patient’s name. You’ll also see the

patient’s nickname, if any, and referral status. Click the “More” button to get a quick view of the

patient’s address, location, and other basic information.

Below that are a set of accordion tabs. Click to expand. The “Referral Info” section contains

information about the patient gathered at the time of referral. The “Change in Care Info” section

contains information about the referral. See below for more details.

The patient homepage will also display HIPAA instructions and basic information like Code

Status, location, phone, etc.

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Editing Patient Information

To view or edit patient information, click on the “Referral Info” accordion tab at the top left of the

homepage (circled).

All of the information entered about the patient as part of the New Referral can be viewed by

clicking on the words “Personal Information”. This information can be edited by clicking on the

edit icon to the right of Personal Information:

Here you can edit the patient’s General Patient Details, Home & Mailing Address, Patient Care

Directives and Military Service Information.

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Editing Referral Information

To view or edit referral information, click on either the “Recent Referral Information” link in the

‘Referral Info’ section of the homepage,

Or the “Change in Care Info” tab at the lower left of the homepage, then “View Summary”.

The Care Level Changes screen shows the just-entered referral. This screen shows a summary

of the referral, including date/time, office, patient location/facility, and county.

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From here, additional information about the referral can be seen by clicking the words “New

Referral (circled). To see additional detail, click the words “New Referral”. To edit, click the edit

icon:

Note: if the patient is in a facility at the time of referral, their location (physical address)

is automatically set to that facility.

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Canceling or Postponing a Referral

Occasionally you may get a referral that doesn’t lead to an admission in a short amount of time.

Consolo offers two methods for categorizing these referrals:

Canceled – The patient will never admit. For example, the patient died after the referral

was received, but before the admission could happen.

Postponed – The patient will not admit soon, but may admit in the future. For example,

after the referral is received, the patient may decide to try one more round of

chemotherapy: the patient will not admit now, but depending on the efficacy of their

treatment, they may admit in a month or so.

Canceled or Postponed referrals can be tracked separately on Reports. To cancel or postpone

a referral, click on the “Change in Care Info” accordion tab at the lower left of the homepage.

Then click on the desired option:

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Here is the “Postpone Admission” screen:

Enter the Date/Time the referral is being postponed, select a new referral status, set a

“Postponed Until” date, and enter any necessary notes.

Here is the “Cancel Admission” Screen:

Enter the Date/Time the referral is being canceled, select a new referral status, and enter any

necessary notes. “Date of Death” may be entered if the patient died before admission and you

wish to follow/support the family in Bereavement.

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Once a patient is postponed or canceled, their referral history is updated. To see this, click

“View Summary” in the ‘Change in Care Info’ section on the patient’s homepage.

The Care Level Changes screen now shows two entries: the initial referral, and the subsequent

postponement of the referral:

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Admitting a Patient

Once a referral is entered, the patient may be admitted if the patient has Payer (insurance)

information recorded. To add Payer information, go to the patient’s homepage, and click “Payer

Information” in the ‘Referral’ section:

Under Related Links, select “Create a new Payer Group”:

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Complete the Payer Group screen:

The patient must have at least a Primary policy. The patient may have up to four policies. Policy

options are:

Medicare

Medicaid

Commercial

Charitable

Once a policy is selected in the Primary Policy (and secondary, etc., if necessary) dropdown

selector, enter the policy details in the Policy tabs at the bottom of the screen:

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Save when finished, and return to the patient’s homepage. Click the “Admit Patient” link in the

‘Change in Care Info’ section of the patient’s homepage:

Complete the Admission screen:

Set the Date/Time to the time of admission

Select the Office to which the patient is admitted

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Click on the ‘Transfer’ button (circled) and complete the following:

Transportation Provider – Select if one was involved in the admission of the patient

Notes – Text field for comments related to the admission

New Level of Care – Required. At what level of care will the patient be admitted?

Fee for Service – Only applies to hospices with Hospice Pharmacia integration

Is a Transfer – Important: if the patient is a mid-benefit period transfer from another

Hospice, you should check this box

Facility – Defaults to the “Planned Service Location” facility, if any. Change if necessary,

or delete/leave blank to admit the patient at home

Room & Board/Subordinate Room & Board – if necessary, select from the available R&B

rates for this facility.

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Now click on the Location tab:

If the patient is located in a facility, or has a facility as their planned service location, the

location will default to that facility; just click Create to finish the Admission

If the patient is not in a facility (the facility field in the Transfer tab is empty), the Location

tab will look like this:

Choose an address from the “Copy from” dropdown selector: Available addresses

include the patient’s home address, and the addresses of any contact/family members

entered on the patient’s homepage

Or, manually enter an address

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Create/save to complete the admission. The patient’s status is now updated to Active, at the

selected Level of Care:

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Multiple Referrals per Patient

Consolo allows multiple referrals to be tracked for an individual patient. For example, a patient is

referred (one), admitted, discharged alive, and then referred again (two), etc. Example:

Re-Admission

To re-admit a patient who was previously discharged alive, click on “New Referral” in the

‘Change in Care Info’ section on the patient’s homepage:

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Then, complete the New Referral worksheet, as described earlier in this document:

Complete the Location information; select a location from the “Copy From” list (the patient’s

address or any contact/family addresses), or manually enter an address:

The patient may now be admitted (or postponed, or canceled):

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Admitting a “Canceled” Referral

Canceling a referral is meant to be a final, irrevocable step. Thus, when a referral is canceled,

there are no further care level changes (referrals or admissions) possible. If a canceled referral

needs to be reactivated, click on “View Summary” in the ‘Change in Care Info’ section of the

patient’s homepage:

On the subsequent Care Level Changes screen, delete the Cancellation event:

Then, the referral may be admitted or postponed.

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Reports

There are two reports related to the referral and admission process.

The Referral Summary Report

This report can be filtered for these variables. Most of the data is pulled from fields within the

patient’s Referral form, shown at the beginning of this manual:

Date Range – Referrals received within the Date Range

Office – Office to which the Referral was assigned

Physician – Attending Physician from the patient’s first Hospice Assignment, or Referral

Physician

Community Liaison – User with this role credited with acquiring the Referral

RN – Assigned RN from the patient’s first Hospice Assignment

Referral Source – External source of Referral

Referral Type – How is the Referral Source categorized in Services/Referrals menu?

County – County wherein the patient was located at the time of Referral

Team – Assigned Team from the patient’s first Hospice Assignment

The report includes the following columns of data:

Patient Name

Referral Date

Referral Office

Location Type – Home or Facility

County

Attending Physician

RN

Referred By

Referral Type

Referral Notes

Referral Status

Community Liaison

Referral Physician

Admission Date

Discharge Date

Postponed Date

Cancelled Date

Date of Death

Evaluation Date

Postponed Until

Notes

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The Admission Summary Report

This report can be filtered for these variables. Most of the data is pulled from fields within the

patient’s Referral form, shown at the beginning of this manual:

Date Range – Date Range within which the patient was admitted

Office – Office to which the patient was admitted

Facility – Facility in which patient was located at the time of admission

Payer – From patient’s Payer Information screen

Indicator – From patient’s Clinical Indicator & Diagnosis screen

Diagnosis – From patient’s Clinical Indicator & Diagnosis screen

Only Readmits – Finds only patients admitted multiple times in the Date Range

Not Readmits – Finds only patients who were admitted once within the Date Range

Physician – Attending Physician from patient’s Hospice Assignment

Community Liaison – From patient’s referral screen

The report includes the following columns of data:

Name – Patient’s name

MRN – Medical Record Number

Office – Office to which patient was admitted

Admission – Date of admission

Facility

Disposition Days – Number of days between referral date and admission date

Indicator

Diagnosis

Payer/Payer Number

DOB

Age

Race

Gender

Religion

Location

County

Zip Code

Physician

Referral Source

Referral Notes

Referral Status

Community Liaison

Referral Physician

Initial Benefit Period

Current Benefit Period

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Reconciling Referrals & Admissions

As you can see, there is some overlap between the reports, but it’s important to remember that

they are compiling and measuring different things. A common question concerns reconciling the

number of referrals and admissions within a given date range.

Example: The Referral & Admission reports are both run for the same date range, e.g. January

2014.

The Referral report will only include patients referred in January, while the Admission report will

only include patients admitted in January.

A patient referred in October 2013 but admitted in January 2014 will not show up on the Referral

report for January, but will show up on the Admission report for January. Likewise, a patient

referred in January but admitted in February will show up on January’s Referral report, but not

January’s Admission report.

Unique Referrals & Admissions

Both reports include a line entry for each event (each referral or admission). So, the total

number of entries (rows) in the report is your total number of referrals or admissions. But

because a patient could be referred or admitted multiple times within a given date range, the

same patient may appear multiple times on either report.

To calculate the number of “unique” referrals or admissions (i.e. counting each patient only

once), use the “Sum Unique Values” tools at the top of each report:

Simply select “Name” as the unique value to calculate:

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Then scroll to the bottom of the report. You’ll see a table that lists each unique patient name,

and the number of times it occurs in the report. The total unique values is your number of

unique referrals/admissions:

In this report, there are 28 total entries, or 28 total admissions. But there are 19 unique names,

or 19 unique admissions. The table of unique names also shows the number of times each

name appears in the report, so you can quickly see that Lane Borer was admitted twice, for

example.

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