The problem
Ready to leave. Nowhere to go.
Patients who need a nursing facility, rehab or home care can't leave the hospital until someone finds a place, gets the insurer's approval and books the move. Today that runs on fax and phone, one facility at a time, while the bed stays full.
Where it breaks
Three steps, all by hand.
Find a place
A packet faxed to one facility after another, waiting on each reply.
Get approval
The health plan's authorization, often days after the facility says yes.
Make the move
Ride, medications and records, lined up for a time that keeps slipping.
Each step waits on the last. The bed waits on all three.
The numbers
Fewer beds. Longer waits.
85%of US hospital beds full by 2032
Projected national hospital occupancy by 2032, up from about 64% before the pandemic and 75% today. Driven by fewer staffed beds, not more patients.
Leuchter et al., JAMA Network Open, February 20251 in 4admitted ED patients wait 4+ hours for a bed
Admitted ED patients who wait four hours or more for a bed. About 1 in 3 in winter, and nearly 1 in 20 wait a full day at the peak.
Janke et al., Health Affairs, June 2025+24%longer stays for patients headed to post-acute care
Growth in hospital stays for patients headed to post-acute care, 2019 to 2022. The care was done. The handoff wasn't.
American Hospital Association, December 20221 in 7med-surg beds held by patients ready to leave
Medical-surgical beds in one state held by a patient who no longer needed hospital care. Some waited months.
Massachusetts Health & Hospital Association, 2023
On the ground
What it looks like on the ground.
One placement, dozens of steps.
A packet rebuilt for every facility. Page 3 never arrives. Voicemail. Declined, no reason given. Authorization days after the yes. A ride nobody booked.
Case managers hold it together by hand.
Thirty patients and one phone. Hours of the day go to hold music, fax machines, and callbacks instead of patients.
Patients and families wait in silence.
She is ready to go, and nobody can tell her where or when. Her family picks from a printed list in an hour, with no idea who has a bed.
One stuck handoff ripples.
The bed stays full. The patient who needed it boards in an ED hallway. The next ambulance is diverted. Tomorrow's surgery is cancelled.
The handoff
Everyone owns a piece. No one owns the whole.
- The hospitalowns the stay.
- The facilityowns the next bed.
- The health planowns the authorization.
- The familyowns the choice.
The handoff belongs to no one. Rondo manages it.
Listen
The Healthcare Handoff
Short conversations with the people who run, pay for and build healthcare, on where care breaks and how we fix it.
Meet the first guestsBring Rondo to your coordination team.
See the loop on your own patients.