Skilled Nursing Facilities

OnsiteCare recognizes the many challenges that the post-acute care sector faces both now and in the coming years.
From the need to reduce 30-day readmissions to the new payment reform models of ACOs and Bundled Payment for Care Initiatives from CMS, we will strive to work with you to help your facility meet both its patient care goals and its financial goals.

We work to optimize patient care in many ways:
  • Through our integrated services between primary care, psychiatry, psychotherapy, podiatry, and optometry teams we have the ability to offer a comprehensive level of service to your patients.
  • Our model of care can significantly reduce 30-day readmission risk in your post-acute care population.
  • Our systematic approach to GDR/deprescribing in your long-term care patients can help patients avoid adverse drug reactions (which currently is one of the leading causes of geriatric ER visits from SNFs).
  • Improved wellness and preventative care services
  • Our use of best practices and comprehensive evidence-based protocols can stabilize patients when more aggressive treatments are needed “in-house.”
  • A systematic approach to the process of Advance Care Planning to ensure a patient’s and/or the POA’s directives for their care. This in turn can help reduce readmission risk and enhance patient satisfaction.
  • You will have a dedicated MD-NP/PA team for your facility on any given day. Meaning, once a team is assigned your facility for a particular day of the week, they are there until the work is done. They are not tasked to go to any other facility for that day.
  • Our clinical team is available to your staff after hours and weekends/holidays through the use of a HIPAA-compliant 2-way text paging system.
Our Medical Directorship yields many benefits:
  • Participate in your QA/PI processes by both Primary Care and Mental Health teams.
  • Evaluate your CASPER report flags and offer thoughts on improving those metrics.
  • Work with SNF leadership on maximizing CMS “star ratings”
  • Work with your pharmacy consultants through our Mental Health team to help reduce antipsychotic, benzodiazepine, and sedative-hypnotic usage rates in your facility.
  • Engage in a tailored antibiotic stewardship program with your facility.
  • Work with your DON/ADON and the rest of your clinical team to address any educational needs
  • Engage with state surveyors when needed
  • Build relationships with your local referring hospitals to improve transitions of care for patients and to improve SNF census.