Situation:
Patient is 45 year-old female with CKD, diabetes, and limb loss. Long term SNF resident that receives dialysis on-site x3 days per week. Dialysis provider routinely checks hemoglobin levels and will not transfuse patient with a reading under 7.0. Patient’s levels present at 6.8; patient will require transfusion before further dialysis treatments are possible.
Case Summary:
Typical course is outpatient visit to the hospital for transfusion; because these patients have multiple chronic conditions, they are admitted in the majority of cases. Typically 2-3 days at a cost of $6,000-$9000. SNF also loses daily bed revenue while patient is admitted. StatPoint provides on-site transfusion within 24 hours for $2,500. Savings $3,500-$,6,500, ROI = 1.4-2.6.
StatPoint RN performs bedside hemoglobin test confirming earlier reading of 6.8. Blood specimen obtained and transported to blood bank, and ultrasound-guided IV catheter placed for transfusion procedure. StatPoint courier delivers blood products the next morning, and StatPoint RN administers. Post-transfusion bedside hemoglobin test indicates a hemoglobin is 7.9, and patient is approved to resume dialysis.
Discussion:
Patients transferring from SNF to hospital is costly for the payer and the SNF operator. If the patient is not in the facility at midnight, the facility receives no revenue for the coming day. While it’s possible to fill the bed in the patient’s absence, it’s not popular, and difficult to do in practice. The availability of advanced diagnostics, procedures, and treatments in the SNF setting is beneficial for the patient, the SNF operator and the payer.
