Guest Blogger, Aric Martin

Aric Martin, Managing Partner at Rolf Goffman Martin Lang, LLP

A lot has changed over the last 20 years. We have become an online, electric, connected and networked society. When was the last time that you were somewhere that you did not have your smartphone or could not access the Internet? Did it make you feel lost? Disconnected? Over 85% of the United States population uses the Internet, including the majority of senior citizens, and nearly two-thirds the population owns a smartphone. 
Not only do we want things quickly, but we want the process to get things to be simple too. Technological innovation is leading to personalized convenience (and our expectations of how interactions with business should proceed).
We have gone from an era of “one machine, many users” (mainframes) to “one machine, one user” (PCs) – and are now entering the world of “many machines, one user” (embedded devices).
Networking giant Cisco estimates that the number of connected devices worldwide will rise from 15 billion today to 50 billion by 2020. Intel is even more bullish, claiming that over 200 billion devices will be connected by then.
Indeed, recent estimates show that 77% of American adults own a smartphone , 66% of Americans own at least two digital devices (smartphone, desktop or laptop computer, or tablet), and 36% of Americans own all three types of devices.  Significantly, the number of Americans owning all three types of devices doubled in size between 2012 and 2105. 
While the world at large and business processes have been revolutionized over the past 20 years, the admission process at skilled nursing facilities continues to exist as an island in a sea of innovation—a time warp where things are done as they have always been done. Skilled nursing facilities (SNFs) continue to require that potential residents and representatives complete admission paperwork in person.
SNFs understand the law requires admission material to be signed at or before admission. Yet, a very large portion of their admissions enters their facilities without signing anything. The SNFs simply shrug and accept institutionalized non-compliance.
It is not uncommon for SNFs to have multiple scheduled (or unscheduled) admissions for the same time. The serial nature of current admission processes coupled with limited resources leads to a backlog. Thus, some residents enter the facility without having signed anything.
Admissions do not always come during the daytime shift. It is increasingly common in our 24/7 healthcare economy for admissions to come after hours and on weekends. This will be even more common as bundling and other new payment models are implemented. Most facilities’ “solution” is to simply violate their legal requirements, and expose themselves to considerable risk, by admitting the after-hours residents without signing any admission material.
Current processes are entirely dependent on human implementation, and are thus subject to costly human error. Typically, an SNF will not know of an error made by its admission personnel, such as the failure to obtain a signature on a critical document, until the matter becomes relevant in a lawsuit or audit.
Current admission processes have passively been accepted by providers for years, despite the legality of electronic signatures, regulatory requirements that admission paperwork be signed before admission, costly missed signatures and human error, slow communication with prospective residents, and staff time utilized coordinating family members and representatives to review and sign paperwork on time.
It is unacceptable that most SNFs have accepted these failures as inevitable. The post-acute, senior living and long-term care community needs to figure out a better way!
For more information about Rolf Law, please contact Aric at,  call 216-682-2100 or visit
Rolf Goffman Martin Lang, LLP dedicates their practice to serving the legal needs of post-acute, long-term care and senior living providers.


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