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On Monday, July 2, 2007, a Medicare patient in a metropolitan hospital, whom we'll call Mrs. Jones, was notified by her physician that she was to be discharged the next day.
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While her husband was sleeping, after a medical procedure, Elizabeth Hogue, Esq., picked up his chart, which was lying on a table in his hospital room.
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Changes in the notifications that hospitals must give Medicare patients about their pending discharge are making discharge planning and careful documentation more important than ever before.
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Cell phones replaced land-based pagers at Richland Hospital in Richland Center, WI, when the area was hit by severe storms and flooding in late August.
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Now that the Centers for Medicare & Medicaid Services (CMS) made the decision to replace the current DRG system with the Medicare Severity-DRG (MS-DRG) system for reimbursement, hospitals will be challenged to provide accurate documentation of patient conditions in order to receive the correct reimbursement, says Deborah Hale, CSS, president of Administrative Consultant Services Inc., a health care consulting firm based in Shawnee, OK.
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With studies showing that 10% of patients are using 90% of the nation's health care resources, traditional case management must move to a disease management model, says Bob Whipple, RNC, CCM, CCS, MHA, a Boston-based senior management consultant with ACS Healthcare Solutions.
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The "yes-means-no" phenomenon was one of several challenges encountered by the team conducting a community case management pilot project for diabetes patients in Nogales, AZ, says Donna Zazworsky, RN, MS, CCM, FAAN, diabetes care center manager for the Tucson-based Carondelet Health Network.
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A disease management program implemented by nurse case managers helps chronically ill unfunded patients cared for by the North Broward Hospital District avoid hospitalizations and emergency room visits.
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Discharge planners/case managers are likely to encounter instances in which home care, hospice, and home medical equipment (HME) providers state that they cannot accept patients because they are "unsafe" at home.