Keeping facility accounts: reviews, reports, and fixing problems before they cost you

Why facility accounts drift away

Winning a facility is the start. Keeping it takes a routine. A facility account is a hospital, nursing home, dialysis clinic, PACE program, or senior community that books rides with you under a written agreement or a standing habit. An account is most at risk when problems repeat and nobody on your side explains them, or when the staff who booked you move on and their replacements never hear your name.

Four habits guard against both:

1. One named person owns each account.
2. The facility gets the same service report every month.
3. You call about problems before the facility’s staff discover them.
4. Renewal talks start early, with a year of numbers in hand.

Our guide to winning facility contracts covers the sale. This guide covers what happens after the agreement is signed.

Give every account one named owner

Pick one person to own each facility, and a backup for days off. In a small company that is the owner or operations manager. In a larger one it may be an account manager with several facilities.

The account owner:

• Knows who books rides at the facility, who approves invoices, and who handles discharges.
• Trains new facility staff on how to request rides, since turnover at the facility can quietly end an account.
• Takes escalations, so a charge nurse with a stranded patient has one number to call.
• Sends the monthly report and runs the review meeting.

Give the facility a short contact card: the dispatch line, the after-hours line, the account owner’s direct number, and who to call if that person does not answer.

PACE programs work this way by regulation. Each PACE organization must name one official liaison who works with all of its contractors, and each contractor agrees in writing to send the reports the organization asks for (42 CFR 460.70). Matching that liaison with your own named contact is the simplest way to meet both. See our PACE transportation guide.

Send the same service report every month

A monthly report turns “we think you’re doing fine” into numbers the facility can take to its own managers. Keep the format identical each month so trends stand out.

Set targets you already meet. Medicaid broker standards show what a demanding buyer expects. MTM Health’s Virginia handbook sets these for its providers:

Keep patient details out of the report unless a line needs them. If HIPAA applies to your company, its minimum necessary standard asks for reasonable efforts to share only the protected health information a purpose requires (45 CFR 164.502(b)). Counts, dates, and your internal trip numbers usually do the job. Our on-time performance guide explains how to calculate the numbers.

Run a short review meeting

The report does most of the work. The meeting is where the facility tells you what the numbers miss. Invite the person who books rides and the person who approves invoices, and keep it to 30 minutes.

A standing agenda:

1. Last period’s numbers against the targets.
2. Each complaint and incident, and the fix you made.
3. Changes coming at the facility: new units, new discharge planners, holiday hours, a moved entrance.
4. Changes coming at your company: new vans, a new driver on their regular runs, new phone hours.
5. Billing questions or disputes.
6. One improvement you will make before the next meeting.

Send a written summary the same day, including the improvement you promised. Then report on it at the next meeting.

Once a year, ask the staff who book rides to rate you in writing on timeliness, driver courtesy, and how easy you are to reach. Share the results at the next review, along with what you changed because of them.

Catch problems before the facility does

Most lost accounts send signals first. Watch for them every week:

When a van is going to be late, call before the patient misses anything. MTM Health’s Virginia handbook makes this a duty: when a pickup is running late, the provider tells the rider or facility and gives a new arrival time. An early call gives staff time to warn the clinic or move the appointment.

Handle complaints so they close

Treat every complaint as a small investigation with a written answer:

1. Acknowledge it the same day. Tell the caller who is handling it and when they will hear back.
2. Pull the record. Check GPS times, the dispatch notes, and the driver’s account before drawing conclusions.
3. Answer in writing. Say what happened, what you changed, and who to call if it happens again.
4. Log it. A complaint log shows trends that single calls hide.
5. Report it. The monthly report should list it with its outcome, even when the complaint was not substantiated.

Show records, not arguments. A trip log with arrival times settles most disputes without anyone raising their voice. Our guide to answering broker complaints covers the same process for Medicaid trips.

Handle incidents fast, and in the right order

Incidents are falls, wheelchair tips, injuries, vehicle accidents, and anything a rider or family could call abuse or neglect. Each one needs a phone call to the facility right away, a written report the same day, and your full cooperation with the facility’s own review.

The facility may be on a clock you cannot see. Under 42 CFR 483.12(c)(1), a nursing home has 2 hours to report an allegation involving abuse or serious bodily injury to its administrator and to state officials, such as the survey agency. Other allegations of abuse, neglect, exploitation, or mistreatment, including injuries nobody can explain, must be reported within 24 hours. A call from you an hour after the ride helps it meet that deadline.

Two other reports may apply:

• The broker, for Medicaid trips. MTM Health’s Virginia handbook counts a failure to report an incident or accident to MTM as one of its most serious infractions, worth 3 points.
• A privacy breach. A business associate must notify the covered entity of a breach of unsecured protected health information without unreasonable delay and no later than 60 calendar days after discovering it (45 CFR 164.410). Your agreement may set a shorter deadline.

Use a standard incident report so nothing is left out, and see our guide to vehicle accidents for the steps at the scene.

Renew the agreement early

Put three dates for every facility on your calendar: the end date, the last day to give notice, and the day you will start the renewal talk. Start at least 90 days before the notice deadline.

Bring a one-page year in review:

• Trips by month and by level of service.
• On-time results by quarter.
• Complaints and incidents, with the fixes.
• Anything the facility asked for that you delivered.
• A current certificate of insurance and copies of any permits the agreement requires.

Then raise what should change: rates, service hours, response times, or new services such as weekend discharges. If rates need to rise, our guide to raising your prices covers notice and wording.

PACE agreements have required terms. Each contract must be in writing and state the payment rate and method, and its beginning and ending dates with the methods of extension, renegotiation, and termination (42 CFR 460.70(d)).

Keep the relationship clean throughout. The HHS Office of Inspector General describes remuneration under the Anti-Kickback Statute as anything of value, including meals and hotel stays. Our anti-kickback guide explains where the lines are. Clean invoices matter as much as clean service; see our guide to facility billing.

Building the monthly report in HealthRide

HealthRide’s on-time performance report and trip log give you the monthly numbers without a spreadsheet: every leg with scheduled and actual times, the driver and vehicle, and GPS-verified miles. The payer summary shows completed trips, cancellations, revenue billed, and what each facility still owes, which is exactly the page you want when a contract comes up for renewal. See reports.