Hospital Case Management
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HINN, IM, and MOON: Alphabet Soup of Forms Can Be Confusing
The Centers for Medicare & Medicaid Services requires hospitals to give patients an array of documents to explain their rights, their status, and any financial obligations they may incur — and it’s usually up to case managers to see that the hospital complies.
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ANA Prepares for Return of Ebola – or Anything Else
As a result of the Ebola outbreak, the American Nurses Association has entered into training and resource collaborations with both the CDC and the Association for Professionals in Infection Control and Epidemiology.
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OB Risk Reduction Focuses on Nurses, Detailed Timelines
While much of malpractice prevention efforts focus on physicians, nurses can be at risk of malpractice charges in this specialty.
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Behavioral Healthcare in ED Improved With Telepsychiatry
Quality of care for behavioral health patients in the ED has been dramatically improved at Rideout Regional Medical Center in Marysville, CA, with a program that aims to get professional help to people in need as soon as possible.
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CMS Delays Start of Cardiac Bundled Payment Initiative
CMS has delayed the effective date of two bundled payments initiatives from July 1 to Oct. 1.
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Observation Unit Cuts Length of Stay, Lowers Costs
Patients who were transferred to the Outpatient Observation Unit at Rockford (IL) Memorial Hospital experienced lower lengths of stay and lower costs than patients who were candidates for observation services but were treated on an inpatient unit.
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Why the Two-Midnight Rule Is ‘Clear as Mud’
There are patients whose condition and circumstances put them in the shadowy area between meeting criteria for an inpatient stay and being an outpatient with observation services.
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OIG: Hospitals Are Still Getting Patient Status Wrong
A report by the U.S. Department of Health and Human Services Office of Inspector General, released in December 2016, concluded that hospitals are billing for short inpatient stays that are inappropriate under the Two-Midnight Rule and for long outpatient stays.
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Top 10 Potentially Inappropriate Stays
The following is a list of potentially inappropriate stays from the Office of Inspector General.
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Be Proactive: Review Your Short Stays Before They Are Billed
Case management directors should take a proactive approach to managing denials and monitor their short inpatient stays, watch for trends, and prevent inappropriate short-stay admissions.