Long-term Post-acute Care Facilities Benefit from a ‘Complete Picture’

Date: April 27th, 2021Category: CORHIO e-NewsletterTopics: HIE, PatientCare 360, Long-Term Care, CORHIO Network, Transitions of Care, Discharge Planning


CORHIO helps Holly Creek Senior Living Community improve communication and care coordination for its residents 

It is estimated that more than 70 percent of Americans that turn 65 years old will need long-term care at some point in their senior years, with many also needing post-acute care services.

Holly Creek Senior Living Community in Centennial, Colo., is a nonprofit continual care community for residents in different phases of aging and needs -- including independent living, assisted living, rehabilitation care, memory care and skilled nursing.

The long-term and post-acute care facility was an early adopter of CORHIO’s health information exchange services, which they use to ensure smooth and effective transitions of care for its residents and meet whatever need that may arise.

HIE provides an accurate picture of residents

Operating since 2005, Holly Creek boasts a five-star quality of resident care rating from Medicare and is ranked among the top 10 percent of nursing homes in the nation by Centers for Medicare and Medicaid Services.

Dawn Davis, Health Information Specialist at Holly Creek, has found CORHIO’s services improve communication among the care teams so the facility can better prepare for residents returning to the community after a hospitalization; especially for those requiring care in its 24-bed skilled nursing unit.

“When a resident in our skilled nursing community was being discharged from the hospital, our nurse was unable to receive the discharge information from the hospital case manager,” she said. “I was able to log in to CORHIO’s PatientCare 360® and see all the information we needed and print it out for the nurse to prepare for the return of our residents. Holly Creek uses CORHIO for every resident coming to us because it gives us a more accurate picture.”

More than 180 long-term and post-acute care facilities now rely on CORHIO’s health information exchange services – to view a list of participating facilities, see our website


Reducing costs while improving health outcomes

Information in PatientCare 360 includes the discharge summary, which offers insight into what medications may need to be ordered and on hand for the resident, equipment the resident may require upon their return (such as a wheelchair) and therapy notes that the therapists can review in advance. PatientCare 360 even helps Davis link prescriptions to medical diagnosis for proper coding.

Beyond the discharge summary, Davis also has found great value in having access to orthopedic surgery notes for residents who required surgery while hospitalized.

“Most recently, I have been using the orthopedic surgery notes since sometimes they are not included in the discharge summary,” she said. “Surgery notes help us with Medicare Transaction System data for claims processing so we can capture everything that is related to that resident. For example, if a patient had a fall, it would code differently --and that is especially important in skilled nursing facilities.” 

Overall, Davis says having access to more complete picture ultimately reduces costs and improves residents’ health outcomes. “CORHIO really helps everything around us,” she said.