Of course, facilities have to weigh the financial and other benefits and risks of accepting higher-acuity patients, says Mark McKenzie of Focused Post-Acute Care Partners.“If you’re in a new market or trying to demonstrate that you’ve added a new competency to meet needs, you will take two to three patients, even if they’re not funded. Then as the program develops and becomes established, you can get them funded and take more patients down the road.

“We have a responsibility to be a socially responsible organization, and that means you will take a loss on some patients. We have 1 to 2 percent of patient caseload at any given time that we’ve knowingly taken at under or zero funding. If we can keep it at this number, it’s just a responsibility we have.”

“Whenever we’re evaluating a patient for admission, we have to be financial stewards for the organization,” says Kimberly Vermilyea of Signature HealthCare. “However, sometimes we take patients at a financial loss because it’s for the greater good of the community.”

Daniel Mendelson from the University of Rochester agrees that there are times when it’s appropriate and even necessary to accept patients who will result in financial losses.

“We don’t make money off of some patients, but by accepting them we open hospital beds that are needed for other patients. If we can treat a patient in a less acute environment and open a bed for another patient, it’s still financially viable for the system overall, even if the facility loses money.”