Manage admissions
RehabAlpha is still under active development. It is not yet HIPAA compliant and should only be used with dummy data.
An admission records a period of care for a patient at the facility that owns the patient record. Use it to organize the patient's therapy cases and billing episodes, and to manage admission details such as admit and discharge dates, room number, physicians, tags, and notes.
Before you start
Create the patient under the correct facility and add any needed coverages first.
Understand admissions
An admission provides the shared context for clinical care and billing during one period at the facility. It can continue through several courses of therapy and changes in payor.
- The admission records the patient's overall period of care at the facility.
- A therapy case records one discipline's course of care, such as physical therapy (PT), occupational therapy (OT), or speech-language pathology (SLP). It contains the clinical documentation for that course of therapy.
- A billing episode identifies the primary payor, billing provider when applicable, dates, and services to which the billing setup applies. Services are selected by discipline or by specific therapy case.
Both therapy cases and billing episodes belong to the admission. One admission can have several of each. RehabAlpha matches a case's services to a billing episode using the episode's dates and selected disciplines or cases.
A therapy case cannot start before the admission date in the facility's time zone. A billing episode cannot start before the admission date and time. When editing an admission, keep its start on or before every case start and at or before every billing episode start.
How the dates fit together
The admission, billing episodes, and therapy cases have separate dates. In this fictional example, one admission continues from January through June. Both billing episodes select PT and OT, and the primary payor changes from Example Payor A to Example Payor B on April 1.
The PT case continues across the payor change; changing the payor does not require a new therapy case or admission. OT ends one course of therapy and starts another later in the same admission. Ending a course of therapy does not mean the patient has left the facility.
A therapy case can also exist before a billing episode is set up. Add the billing episode when you need RehabAlpha to match services to a primary payor and payment model. For more examples, including billing episodes that apply to different disciplines at the same time, use the billing episode guide.
Add an admission
- Open the patient.
- Click Admissions.
- Click New admission.
- Enter the Admit date. Add Admit time when known, or leave it blank.
- Add room number, physicians, prior hospitalization, or PDPM assessment details when available.
- Set up a billing episode if your organization tracks billing setup in RehabAlpha.
- Click Save.
RehabAlpha derives the facility, time zone, available service locations, and billing defaults from the patient's facility. The admission form does not let you select or change the facility or time zone.
Admit time is optional. If you leave it blank, RehabAlpha uses midnight (00:00) on the admit date for calculations, in the time zone shown in the field's help popover. The time stays blank when you reopen the admission, and admission summaries show only the admit date.
For a readmission on the same day as an earlier discharge, enter an admit time at or after the discharge time. Leaving the time blank assumes midnight and can overlap the earlier admission.
Update an admission
- Open the patient.
- Click Admissions.
- Open the admission.
- Click Edit.
- Update admission details, physicians, PDPM assessments, billing episodes, tags, or notes. The facility remains unchanged.
- Click Save.
The admission keeps the facility time zone saved when it was created, even if the facility's time zone later changes. Admit, discharge, and custom billing-episode dates and times use that saved zone. Clearing Admit time restores the midnight assumption.
End an admission
Use the admission's Discharge date when the patient is no longer admitted at the facility.
- Open the admission.
- Click Edit.
- Enter the Discharge date.
- Review any billing episodes tied to the admission.
- Click Save.
Discharging an admission doesn't close its therapy cases. Write a discharge or set an end date on each case when its course of therapy ends.
Combined PointClickCare stays and time away
When a resident leaves for the hospital and returns, PointClickCare (PCC) can record two separate stays. Depending on the facility's combine setting, a refresh can add the returning stay to the earlier admission so therapy cases continue. When an admission combines stays, its Time away from facility section lists when the resident left and returned. Admissions with a single stay don't show this section.
Billing after time away
Combining stays never makes time away billable.
- If the resident returned the same day, billing episodes continue as before.
- If the resident was away overnight, billing episodes that were in effect when the resident left end at that time. The admission shows Billing needs review after return until a billing episode covers the return.
To bill the return, edit the admission and either add a new billing episode starting at the return or extend the earlier episode. A PDPM case-mix per diem episode that continues across time away needs interruptions covering every overnight date away, and it can't bridge more than 3 such dates. See Set up a billing episode.
See an admission's PointClickCare stays
For a patient linked to PCC, the admission's Integration section lists each PCC stay in the admission, with its admit and discharge times, and the PCC identifiers. It also shows when the patient was last refreshed. PCC refreshes update the admission's admit and discharge dates and time away, and can fill an empty physician list; other details stay as entered in RehabAlpha.
An admission you created in RehabAlpha shows Not linked, and PCC refreshes don't change it. Refreshes run for the whole patient, so refresh from the Integration section in the patient's details.
Combine an admission with the next one
- Open the earlier admission.
- Click Combine with next. It appears only when the next admission is a PCC admission in the same setting.
- Type combine and confirm.
You can combine an admission only with the next PCC admission in the same setting (inpatient or outpatient). The later admission can't have therapy cases, billing episodes, or files, because cases can't move between admissions. The later admission is deleted. Its room number, physicians, notes, and tags are discarded.
Separate a stay
- Open the admission.
- In Time away from facility, find the return that starts the stay you want to separate.
- Click Separate, type separate, and confirm.
The returning stay and any later stays become a new admission. The earlier admission then ends when the resident left. Before separating, end or discharge every therapy case in the earlier admission on or before that day, and move any documentation dated after it. The new admission starts without billing episodes, physicians, or other details. Later refreshes keep separated stays apart.
What to do next
After an admission exists, start a therapy case for each discipline providing care.