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SMHC SNF/ED Transfers
Communication Improvement Project

Greetings Cross-Continuum Team!

The forms on this page are to be used for the SMHC SNF/ED Transfers Communication Improvement Project. SMHC's Emergency Department, local EMS and nursing homes are partnering to improve the communication process.


Contact Information


Project Participants
SMHC Emergency Department
Biddeford Campus: Wynne Sholl
Sanford Campus: Lillian Watterson
EMS Companies
Sarah Scott
Operational Excellence
Mary Page
 Participating Facilities
Greenwood Center
Anna Rabassa
Kennebunk Nursing Center for Health and Rehab
Larry Strickland
Maine Veterans' Home
Nora Holliday
Newton Center
Roger Caron
Kathy Fernberg
River Ridge
David Langstaff
Seal Rock
Melissa Cantara
Eric Pooler
St. Andre Health Care
Stephen Alaimo
Varney Crossing
Barbara Rentz-Champagne


MaineHealth Contact:
Sharon Foerster, 207-661-7595

As you use the forms, feel free to provide feedback to Sharon Foerster in between meetings.

** In the course of your pilot, immediate communication is expected if the pilot process adversely affects patient care in any way. **

Pilot Process Map
This is an overview of the current process, with flagged areas for improvement/change.
Under Development

To be used by the SNF/NH, ED, OneCall and/or EMS.

Transfer to ED Document Checklist
This form is placed on the outside of the manila envelope.

Resident Transfer Form
This form is placed inside the manila envelope and includes most important resident information.


SBAR Forms

One-Page SBAR Document



(2) INTERACT® SBAR Form This form is also available on the INTERACT® website. Please note that you must go to the INTERACT® website and agree to use the INTERACT® Licensed Materials as described in the terms of agreement. You may want to use this form for training staff but not to send to the ED.

Homes might use their own type of form to document the SBAR communication.

Transfer Form - ED Discharge to Nursing Home
This form was created with SMHC ED input.
Face Sheet
This form will be specific to each SNF/NH but contains standard information.
Current MAR
This form will be specific to each SNF/NH documentation.
Advance Directives and Code Status Documentation
Will be what the SNF/NH has on record for the resident. The POLST form will be a state form if the resident has previously filled one out.

Process Tracking Form


 Data Tracking Form
This form is to be used by the SMHC ED and the SNFs in the pilot. Staff from any location (SNF, ED, EMS and MaineHealth) can use this form to track data and document comments. Please send the form to Sharon Foerster each Friday after the beginning of the pilot. The sub-group will review results periodically.





MMC SNF/ED Transfers Process


Pen Bay SNF/ED Transfers Process

110 Free Street | Portland, Maine 04101 | (207) 661-7001