Patient Criteria and/or 25% Rule Compliance Engagement


  • Assist with pre-admission process and census development opportunities within the Patient Criteria and/or 25% Referral Source threshold

  • Assess monitoring methods and provide recommendations to improve internal auditing of admissions data

  • Develop an admissions plan that balances census development within the Patient Criteria and/or 25% threshold to avoid potential payment reductions


  • Before we arrive on-site we will analyze market data from your acute-care beds and primary and secondary markets to determine the potential volume in your market place by MS-LTC-DRG.

  • While on-site we will assess your admissions department with interviews and observations of liaison activities and referral outcomes management reports.

  • We also analyze your outcomes data by referring hospitals to identify risks and opportunities within your current admissions processes.

  • We will explore opportunities to expand beyond the current market, including evaluating alternative patient populations.

  • Based on the above observations and analysis, we will develop an admissions plan to effectively manage percent of admissions from your referring hospitals.


  • Admissions plan, in accordance with the cost-reporting year, to ensure effective management of the Patient Criteria and/or 25% threshold and strategies to improve census while avoiding payment reductions

What other programs does Fleming-AOD Consulting offer? »

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3rd Floor   |   816 Thayer Ave.  |  Silver Spring, MD 20910