Hospital Case Management
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Audits highlight need for documentation
The Centers for Medicare & Medicaid Services Probe and Educate initiative to determine hospitals compliance with the two-midnight rule makes it clear that case managers must review physician documentation as well as medical necessity. -
Experts: Know your patients’ benefits and work to conserve them
Case managers should know their patients insurance benefits and out-of-pocket expenses when they develop a discharge plan to make sure the patient can afford the plan they are putting in place. -
CMS sounding alarm on unsafe needle practices
As outbreaks continue to be reported due to unsafe injection practices and improper use of medication vials, the Centers for Medicare & Medicaid Services (CMS) is telling its surveyors to contact public health departments immediately if they see such flagrant breaches of infection control. -
Visual cues keep treatment team alert
At Good Samaritan Medical Center in West Palm Beach, FL, a throughput initiative that uses colored magnets to indicate anticipated discharges has cut emergency department holding time and increased the number of discharges by 2 p.m. -
Heart failure program cuts readmission rate
After Southeast Alabama Medical Center in Dothan began a heart failure readmission prevention program, its 30-day readmission rate dropped to an average of 13%. In January, the hospital discharged 62 heart failure patients and only 8% were readmitted. -
Being creative when benefits are maxed out
When patients benefits have been maxed out or are close to being maxed out, case managers need to be creative with discharge planning, experts say. -
Decreasing preventable readmissions?
Bioethicists can advocate for improved communication with family caregivers when a patient is going to be discharged from the hospital. -
Knowing benefits helps patients make choices
When BK Kizziar, RN-BC, CCM, was in the hospital following surgery, a case manager walked into her room the day before discharge and asked whether she wanted to go to an acute rehab facility or have physical therapy sessions at home. -
CMS flu shot reporting raises thorny issue of vaccination status of hospital workers
Patients will soon be able to check the influenza vaccination rates of healthcare workers at the nation’s hospitals through Hospitalcompare.gov, a website of the Centers for Medicare & Medicaid Services (CMS). That specter of public reporting has helped spur the rising rates of flu vaccination in hospitals, but it will also reveal the continuing problem of tracking the vaccination status of doctors, advanced practice nurses and physician assistants who are not hospital employees. -
Weight-loss program involves the entire family
When young, obese California Medicaid beneficiaries enroll in Health Net’s weight management program, a health coach involves the entire family in the program, called Fit Families for Life.