The Trella Health Solutions allow you to trace the aggregate flow of patients through the continuum of care. The Facility Referral Sources table identifies the hospice's patients that were admitted within 30 days of discharge from the facility listed in each row. For more information, see Patient Sources and Destinations. On the Hospice Detail page, the Facility Referral Sources table contains a complete list of facility patient sources "upstream" from the hospice featured on the page. The table contains facility data for Inpatient, Outpatient, SNF, and Home Health sources; each of these different source types can be found in the separate tabs across the top of the table.
The tables contain four sections:
- Facility Identification - The name and NPI of the source facility.
- ALL Hospices - This section contains hospice patient data for the facility in the row as it pertains to ALL related hospice destinations. This data is a baseline for understanding the facility's discharge performance and also provides metrics for comparison to the agency specific data contained in the next section.
- This Hospice - The four metrics in this section are specific to the hospice on the detail page. These provide a view of the patient flow from the facility listed in the row and the hospice of interest.
- Patient Counts by quarter - In order to capture trends, patient counts between the source and destination are broken down over the past 8 quarters.
Do not consider any of the data in this table to be indicative that an actual "referral" took place. We identify patients who were coded at discharge for a specific type of post acute care. We also focus on patients who were admitted to hospice within 30 days of discharge to increase the likelihood that the count represents a connection between discharge and subsequent care. These metrics indicate a likely connection but do NOT indicate that a referral took place.
There are five tabs at the top of the Facility Sources table. Each tab indicates the type of facility source contained in the table below. The content (columns of data) in each tab type is the same for all tabs except for the Inpatient/Outpatient tab which includes a single extra column called "My Market Share."
Understanding the Data
On the one hand, if you are a hospice services provider, examining your own performance metrics on the hospice detail page provides useful insights into your patient sources, market position, and overall success. On the other hand, this page is a powerful tool to help you to understand the same metrics for your competitors. For example, examining your competitor's facility sources allows you to drill down further to the facility's detail page to do a direct comparison of relative hospice performance for a shared patient source. If you find a source facility that is sending more patients to a competitor, but you can show better care provided to their patients, you have a great sales story to present to that facility.
Making the connections
Although there is nothing in the claim data that identifies that a referral took place, there are elements in the data that we have used to help identify a higher likelihood of a connection between a prior facility and admission to the listed hospice.
- 30 day Reference period - All patient counts include patients who were discharged from the listed facility and then admitted to the hospice on the detail page within 30 days. This allows us to infer a connection between the discharge and subsequent hospice care.
- Discharge Coding - Discharge claims include a "Patient Status" that indicates the status of the patient as of the through date of the billing period. This specifies the next type of care intended by the staff of the discharging facility for the patient. Although there are several codes possible, in this table we focus on the number of distinct patients who were coded for hospice care at discharge
Another useful path of inquiry is to evaluate whether patients from a listed facility are following discharge instructions. In an ideal situation, when a patient is discharged from one type of care, they would be directed to the next required care seamlessly. In these cases, we would find that, for example, a patient discharged from a hospital would be appropriately coded for hospice care, and would then (soon) be admitted to hospice. This is why we track the metric, Patients with Hospice Discharge Instructions in addition to the metric Patients who Received Hospice Care. There are two opportunities that can be identified in these metrics:
- Patients who are discharged from a facility with no instructions to seek hospice care, but eventually seek hospice care, and,
- Patients who are discharged from a facility with instructions to seek hospice care, but who are not admitted to hospice care.
These scenarios are visible in the data when we compare Total Hospice Patients, Patients with Discharge Instructions, and Patients who received Hospice.
Although the data on the Hospice Detail page in the Facility Referral Sources table can tip you off to the two opportunities, it is best to click on the facility name in the table and go to the facility detail page. There you can examine the Post Acute Destinations table to get a more in depth understanding of Discharge Adherence. For more information, see, Facilities Detail Page - Post Acute Destinations/Discharge Metrics and Discharge Adherence.
|Facility Name/NPI||Facility Name and NPI, as listed in the CMS Provider Data (NPI) file. This name is a link to the detail page for the listed facility. If needed, you can add an alias to this name to make it searchable by another name.|
|All Hospices||Total INP/OUTP/SNF/HomeHealth Patients - This Facility||This column includes the count of distinct patients discharged from the facility in each row who were admitted into any hospice facility within 30 days of discharge.|
|Patients with Hospice Discharge Instructions||
This metric is the count of patients who were coded as discharged to hospice.
This metric should not be construed to suggest that any actual instructions were provided to any patient. The metrics in this table only identify the status coding at discharge.
|Patients who Received Hospice Care||This count specifies the number of patients discharged from this facility who received hospice care (at any hospice) as specified in the discharge instructions within 30 days of discharge.|
|This Hospice (refers to the hospice listed on the detail page.)||Total Hospice Patients||This is the number of patients discharged from the facility in each row who had claims filed for hospice care at the hospice facility on this page within 30 days of discharge.|
|My Market Share (Only on INP/OUTP tab)||This number is the percentage of hospice patients that the selected hospice received from the total patients discharged from the facility in each row. (Equation: Column 6 divided by Column 3 multiplied by 100%)|
|Patients Discharged to Hospice||This count is the number of patients discharged from this facility with instructions to seek hospice care (Discharge Code indicates Hospice care needed) and had claims filed for hospice care at the hospice on this page within 30 days of discharge.|
|ALOS||This is the average number of days patients discharged from this facility spent in the hospice on this page, for patients discharged from hospice during the one year reporting period and treated by the hospice within 30 days of discharge from this facility.|
|Counts by Quarter||Quarters are list by Year-Q#||These columns contain the counts of distinct hospice patients admitted to the hospice on this Page from the facility in the row during the quarter in the column header|