Considerations when making a referral for Skilled Nursing Care

Patients are transferred from the hospital to a skilled nursing facility at lightning speed. The amount of physical, occupational, and speech therapy services a patient receives is based upon the patient’s tolerance. Here are considerations for the health care professional as they make recommendations for continued care.

• Does the patient live alone, with family, or friends?
• Is the family able to meet the mental or physical demands of caring for their loved one at home?
• Does the patient have outside support systems to make the discharge safe?
• Does the patient understand how to take their medications?
• Can the patient explain or describe what medications they currently take?
• Can family or friends understand the patient’s medications or treatments?
• Are there any physical plan challenges with the patient returning to their prior living setting?
• Are there steps or long distances to critical rooms like the bathroom or bedroom?
• Would the patient benefit from a short-term skilled nursing care stay before transitioning home?

Referral Information Needed

Often, hospitals utilize Provider Link to facilitate a skilled nursing care referral. Liberty Healthcare and Rehabilitation Services is able to have a staff member meet with the patient, their family, or the patient’s medical professional, to conduct a complete evaluation of the patient and coordinate an admission. Click here to learn about our facility locations. Our facilities coordinate referrals with a variety of medical professionals and are able to accept an admission twenty-four hours a day, seven days a week.

• North Carolina FL2
• History and Physical
• PASSAR Number
• Current Medications (Medication Administration Record)
• Discharge Summary
• Current Therapy Notes
• List of Equipment Needs