It is a common understanding. How many of you are really taking the time to work with your continuum of care providers to streamline processes and improve the continuum of care? Most of the articles do not tell you several of the fine points hospitals and nursing home leaders should talk about to improve this in a short period of time. If you wait for QIO designated vendor to bring all of the key players together, you may wait for several months. It is a slow process and it does not have many teeth in the process. At the end of the day, most of the hospitals have some unique things in place with the setup, doctors, and patient populations.