| name | admissions-funnel-analytics |
| description | Veteran playbook for reading the hospice referral-to-admission funnel — the stage definitions tied to observable events, conversion rate, time-to-admission and same-day admits, the declined-referral root-cause taxonomy with an owner for each, average daily census and length-of-stay reads, and the activity-to-census model. Consulted by admissions-conversion-coach. A referral is not census until it converts. |
Admissions Funnel Analytics Skill
Purpose: help admissions-conversion-coach read the funnel honestly, find the leak, give every decline a root cause and an owner, and connect activity to census. A referral count is never census; a converted, admitted patient is.
When to use
- Reading the funnel for a leak.
- Diagnosing a conversion drop.
- Setting up honest tracking.
- Connecting activity to a census target.
1. The funnel stages (tie each to an observable event)
| Stage | The observable event | Watch |
|---|
| Referral | A source sends a patient for consideration | Volume, source mix |
| Eligibility screen | A clinical review of appropriateness | Ineligible rate (an upstream education signal) |
| Information visit | The informational/election conversation with patient/family | Family-declined rate (a goals-of-care signal) |
| Election / consent | The patient elects the benefit | Time at this stage |
| Admission | The patient is admitted to service | Time-to-admission, same-day rate |
Conversion is measured stage-to-stage and overall (referral → admission). Stages move on events, not optimism.
2. Conversion analysis
- Overall conversion = admissions ÷ referrals. Stage conversion isolates the leak.
- Compare against a benchmark band — but treat any external number as
[example — calibrate to your program]; published hospice conversion benchmarks vary widely by market and source mix.
- The leaking stage points to the owner (see the root-cause taxonomy). Run
scripts/hospice_calc.py funnel for the arithmetic.
3. Declined-referral root-cause taxonomy (every decline gets a cause and an owner)
| Root cause | Likely owner / fix |
|---|
| Ineligible (not yet hospice-appropriate) | Upstream education — hospice-eligibility-educator; also a possible late/early-timing signal |
| Family / patient declined | The goals-of-care conversation — goals-of-care-conversation-coach |
| Lost to another agency | Responsiveness / relationship — referral-account-manager, time-to-admit |
| Response too slow | Intake / staffing / after-hours capability |
| Patient died before admission | The late-referral problem — the highest-value upstream education target |
| Facility re-routed (relationship) | The account relationship — referral-account-manager |
"We lost some" is not a diagnosis. Every decline carries a cause and an owner, and the mix tells you where to invest.
4. Time-to-admission & same-day admits
Time-to-admission is a conversion lever, not a logistics footnote: a slow response loses referrals to faster agencies and, worse, can mean the patient dies before admission. Track the elapsed referral-to-admission time, the same-day-admit rate, and after-hours/weekend admit capability.
5. Census & length of stay
- Average daily census (ADC) is the running result of admissions − discharges over time — the program's true size. Run
scripts/hospice_calc.py census.
- Length of stay (LOS): average and median. A short LOS (and a high share of very-short stays) is the signature of late referrals — read it as an upstream education gap, not an intake problem. Median LOS is more honest than mean (a few long stays skew the average).
6. Activity-to-census model
Work backward from a census target: a target ADC, sustained at an average LOS, requires a steady admission rate, which (at your conversion rate and time-to-admit) requires a referral rate, which sets the activity target. This grounds activity goals in arithmetic instead of habit. The model and the math live in scripts/hospice_calc.py (census + funnel).
Hand-offs
- Top-of-funnel volume too low →
referral-territory-development skill / referral-development-strategist.
- A specific partner driving declines →
referral-account-planning skill / referral-account-manager.
- Eligibility-driven declines →
hospice-eligibility-criteria skill / hospice-eligibility-educator.
- Family-declined declines →
goals-of-care-conversations skill / goals-of-care-conversation-coach.
- Building the reporting dashboard →
data-platform plugin (a reporting build, not a referral-conversion question).
