Hospital Case Management – July 1, 2009
July 1, 2009
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Preparation is the key to staying ahead of the curve during RAC reviews
The more your hospital does up front to prepare for Medicare's Recovery Audit Contractor (RAC) program, the more money it will save in the long run, experts say. -
Early days of RAC reviews are the easiest
Don't get a false sense of security if the Recovery Audit Contractor (RAC) process seems easy at first, warns Brian Flood, CHC, CIG, Esq., advisory managing director for KPMG LLP's health care practice in Austin, TX. -
RACs focus on details, admission orders
During the Recovery Audit Contractor (RAC) demonstration project, the auditors were extremely focused on the level-of-care orders to the point of denying admissions that did not have a clear admission order such as "admit to inpatient." -
CMs' role in a pandemic is to keep patients educated
Case managers can play a vital role in the event of a pandemic by educating their patients on how to stay healthy and avoid exposure to disease. -
Critical Path Network: Create an appropriate discharge plan to avoid lawsuit
Case managers are under pressure to discharge patients as quickly as possible from the acute care hospital, but they may have liability for negligent, premature discharge, according to Elizabeth Hogue, Esq., a Washington-DC based attorney specializing in health care issues. -
Critical Path Network: Hospital discharge process can be more efficient
While hospital discharge planners make certain each patient's discharge and transition in care are handled with quality of care and safety in mind, it's the job of hospital operations chiefs to make certain the entire process runs smoothly and efficiently. -
Critical Path Network: Discharge support may prevent, delay readmission
Researchers who reviewed thousands of studies have found that enhanced hospital discharge support might prevent or delay hospital readmissions for heart failure and stroke patients. -
CMS proposes few coding, reporting changes in IPPS
The 2010 proposed rule for the Inpatient Prospective Payment System (IPPS) includes only minimal changes to the MS-DRG system from a coding and reporting standpoint but is likely to have a significant impact on hospital reimbursement, according to Deborah Hale, CCS, president of Administrative Consultant Services LLC, a health care consulting firm based in Shawnee, OK. -
Nurses share document improvement ideas
When the RN clinical documentation improvement specialists at Central DuPage Hospital set up a networking meeting with their peers from other hospitals in northern Illinois, they never dreamed that their efforts would lead to the formation of a new organization with regular meetings. -
Launching new organization takes time and effort
It took Nancy Sikorski, RN, BA, nearly four months of research, telephone calls, and e-mails to bring together some of the RN clinical documentation improvement specialists in northern Illinois for a meeting. -
ED/hospitalist plan improves throughput
A new plan for admitting patients from the ED at Johns Hopkins Bayview Medical Center in Baltimore jointly developed by an ED physician and a hospitalist, decreased ED throughput for admitted patients 98 minutes (from 458 minutes to 360 minutes) from the same period a year earlier, despite an 8.8% increase in the ED census.