Hospital Case Management 2007-10-01

Documentation is more important than ever under MS-DRGs

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.

'Present on admission' could have big effect

Beginning Oct. 1, as part of the Centers for Medicare & Medicaid Services (CMS) shift to value-based purchasing, hospitals will have to report the "present on admission" indicator for every diagnosis reported for a patient.

Delivering the Medicare Important Message

If your hospital is having difficulty complying with the new Medicare rule for notifying patients of their right to appeal their discharge, you're not alone.

Guest Column: When are patients deemed 'unsafe' for home care?

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.

Critcal Path Network: Poster alerts patients to their discharge responsibilities

Patients at Seton Medical Center are made aware of their proposed discharge date early in the stay through a laminated poster with a Wizard of Oz theme titled "The Road Home."

Critcal Path Network: Disease management plan helps unfunded patients

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.

Discharge Planning Advisor: Project targets diabetes in Latino community

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.

Discharge Planning Advisor: Consultant: CM must move to DM model

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.

Discharge Planning Advisor: RTI reviews Medicare chronic care programs

Eight Medicare chronic care improvement demonstrations cost more than they saved in their first six months, according to an early review of the programs by RTI International.

Patient Safety Alert supplement

Hospital Case Management – October 1, 2007

October 1, 2007