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Until a hospital's executive administrators truly acknowledge that case management is part of the cost of doing business, it's likely that those charged with performing that task will continue to struggle with daunting workloads and inadequate staffing, says Karen Zander, RN, MS, CMAC, FAAN, principal and co-owner of the Center for Case Management in South Natick, MA.
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A one-word change in the Conditions of Participation (CoP) regulations that went into effect Jan. 26, 2007, will make a dramatic difference in compliance requirements for Medicare and EMTALA, says Stephen A. Frew, JD, a web site publisher and risk management specialist (www.medlaw.com).
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A quality improvement project for hysterectomy patients resulted in a decrease in length of stay from 1.89 days to 1.24 days for patients receiving a vaginal hysterectomy and from 2.59 days to 2.23 days for patients receiving an abdominal hysterectomy at Ingham Medical Center in Lansing, MI.
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At Ingham Regional Medical Center in Lansing, MI, social workers and case managers work closely together to arrange post-discharge care of dialysis and ventilator patients on the nephrology unit.
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Many top hospital decision makers still fail to recognize that case management is a core function of patient care, not an optional service that needs to prove return on investment, says Karen Zander, RN, MS, CMAC, FAAN, principal and co-owner of the Center for Case Management in South Natick, MA.
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The Centers for Medicare & Medicaid Services has released guidance to help organizations comply with HIPAA security standards when they allow remote access to electronic protected health information (EPHI) through portable devices or external systems or hardware.
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When it comes to coding, a rose by any other name may mean that your hospital isn't getting the reimbursement it deserves.
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Case management involvement in the documentation enhancement process can be limited to monitoring specific DRGs and collaborating closely with coding specialists to an environment where the case management department has staff whose entire focus is on documentation enhancement, asserts Lorraine Larrance, BSN, MHSA, CPHQ, CCM, manager with Pershing Yoakley & Associates, a Charlotte, NC, health care consulting firm.
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In today's health care environment, it's more important than ever for hospitals to make sure that documentation in the patient record reflects the severity of patients' conditions and the level of services they receive.
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When Sarasota (FL) Memorial Hospital began experiencing a big spike in emergency department diversion, the hospital created a multidisciplinary committee to determine why the diversion was occurring.