Rethinking Admissions in Response to Covid - SMARTMD Rethinking Admissions in Response to Covid - SMARTMD

Restricted access to patients in nursing homes and hospitals has thrown a monkey wrench in hospice admission process. Explaining services, obtaining signatures, and gathering paperwork from patients and family are now suddenly complicated by the fact family members aren’t allowed in the facility, can’t travel, or simply won’t participate in person due to risk of infecting their loved one. You can either create workarounds for the situation, or, take advantage of the change to stand out from your competition.

A Leader’s Perspective

COVID-19 is upheaving practically every aspect of daily life and business, to a degree many of us will likely never witness again in our lifetimes. As business leaders, we can interpret the disruption either as a crisis or as an opportunity. Seen as a crisis, we will respond with mitigation and risk reduction measures, with the objective to minimize loss. But if we look at disruptive change as a rare point in time when buyers are more willing to change habits, then COVID-19 may be an opportunity for rapid growth and building competitive advantages. (“3 Steps for Reimagining Your Business for a Post-COVID World”)

This is not a new idea. Successful organizations have responded to external stimulus by doing more than coping with the change. They use the event to create competitive advantages. Three specific examples come to mind.

Remote Admissions – the New Normal

Face-to-face admission visits won’t be the same for a long time to come. In the past, caregivers almost always attended the admission visit. That’s no longer the case given that infection rates remain elevated in the US and the high mortality rate of older patients who contract COVID-19. It is not surprising that family and sometimes even nurses are no longer able to visit patients in nursing homes, rehab centers, assisted living, and hospitals. If even 10% of your patients are transferring from one of these facilities, chances are that caregivers won’t be present during the admission visit for the foreseeable future. For your patients that aren’t lucid, that means either you engage family & DSS staff remotely, or you lose the business.

Step 1: Evaluate Your Current Admissions Process – ALL of It

We all know that the admission visit is about much more than simply getting paperwork signed. Nurses viscerally demonstrate their compassion, communicate what hospice is (and is not), educate family, and trust is established. That’s on top of the exam, medication reconciliation, and clinical documentation. But the admission process didn’t start at the visit. In fact, multiple members of your organization may have already contacted the patient and family long before the nurse or social worker arrived.

The knee jerk reaction to the current lack of patient & family access is simply to send paperwork via email and expect patients to print, fill, sign, and fax back. First, I can’t imagine anything more antithetical to the tenets of hospice. Sending a contract via email does NOT convey compassion, understanding, or invoke trust. It is cold and calculated, often confusing for the recipient, and may create more questions than it answers.

You’ll also want to consider that the tools available to your customers are changing. There was a time many of us actually had a fax machine at home. In the US, that number was down to 3% of households as early as the 1990s! (“Japan: The Country Where 59% of Households Still Have a Fax”) Some adults don’t own a printer either, opting to do everything on their laptops. On the other end of the spectrum are patients who don’t have a computer or internet. In fact, the most common technology tool are smartphones, with 81% penetration in 2019. For adults who are likely the caregiver or hospice power of attorney, adults aged 30 to 49, that number climbs to 91% (Pew Research: Mobile Fact Sheet)

Step 2: Design an Experience

At least once, you should go to a Disney theme park and sit through a character meal. Disney uses the setting, cast members, sounds/music to transform a simple meal into a magical experience. They think of everything about the experience, not just the food (in fact, the food isn’t even that good). High end restaurants do the same, but to a lesser degree.

You can approach remote admissions with the same expanded thinking. Consider the following elements of the experience for patients, family, caregivers, and proxies:

  • Will the the experience make them trust you more.
  • How will they sign paperwork. This is the most obvious & basic feature.
  • Can paperwork started online be finished by admission nurses in person.
  • How will you empower them to provide their own documentation; does the admission nurse really have to collect paperwork at admissions? (look at what banking is doing with onboarding new customers)
  • They should be able to participate from their desktop, laptop, and/or from their mobile phone.
  • Multiple parties should be able to collectively (one or all) participate in various steps.
  • For mobile phone users, read content without resorting to a magnifying glass.
  • Will they be able to navigate through the experience on their own, or will they end up calling your staff multiple times for help.
  • For the visually impaired, they should be able to listen or watch.
  • For the impatient, or simply time constrained, they should be able to listen or watch.
  • How can the process be modified to reduce health risk for your staff.
  • What about post admissions? Just like Tesla, the customer experience does not end at purchase. For caregivers, they for example, may want a copy of signed documents, handbooks, educational material, longer after admission.

Step 3: Build the Experience

A common thread across the companies we’ve researched is that they all created an online experience for their customers. Let me repeat, they created an entire online experience. They did not simply shoe horn in feature or function into their process. Target and Telsa built out a web + mobile + physical experience that was designed just for their audience that took into account the unique capabilities, preferences, and needs of their users.

If you want to compete, you’ll need to do the same. Simply sending forms out for electronic signature will not cut it. In our next article, we’ll review lessons learned from one agency that made the investment – what worked, what didn’t go as planned, what it took to implement, and outcomes.

If you can’t wait that long, you can look at our out-of-the-box solution for online admissions. You don’t have to start from scratch. You can use our platform to jump start your new admissions experience.


The response to COVID-19 has been a paradigm shift for consumers and businesses alike. Treating the situation as a temporary suspension of previous behaviors would be a mistake. Technology is being used to make processes easier and, in some cases, entirely replace them. Companies can emerge in a post-COVID-19 environment stronger than they entered. But only if they view it as a chance to improve, not just survive.