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Your hospital could lose its Medicare or Medicaid certification if you dont take care to ensure that patients who need home health services or a referral to skilled nursing facilities are given a choice of providers and not just steered to those in which your facility has an interest.
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When patients at Haywood Regional Medical Center in Clyde, NC, need post-discharge services, they can look for information about the providers they are considering in the hospitals Western North Carolina Provider Directory, a binder compiled by the case management staff and filled with information on home health services, skilled nursing facilities, and durable medical equipment providers.
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Todays discharge planners face the challenge of finding post-acute services for patients who, thanks to improvement treatments and technology, survive more catastrophic illnesses and injuries than ever before. However, many of these patients are medically stable and need to go to a lower level of care. Finding a facility that will take clinically complex patients often is difficult for hospital discharge planners.
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Hospital-based case managers are facing mounting challenges today, from the aging of the population and the rise in chronic health conditions to the escalating cost of health care services and advancements in medical technologies. They are especially pressured to ensure that clients have access to cost-effective, appropriate, timely, safe, and efficient health care services.
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When patients leave St. Vincents Medical Center in Jacksonville, FL, with referrals for post-discharge services, they take home a copy of the hospitals self-determination referral form, with information details about which providers they chose on the front and the list from which they made their choices on the back.
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Care costs, demand increased in 2003; AHRQ tool offers help to assess hospital safety; CMS releases paper on HIPAA security rule
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A scoring system for assessing which patients are most ready to be discharged from the hospital can be an important emergency preparedness tool, suggests Pat Orchard, CCM, CHE, director of health services for Horizon Blue Cross Blue Shield of New Jersey, based in Mount Laurel.
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As President Bush begins his second term with an emphasis on medical malpractice reform, a survey of health care experts and innovative thinkers conducted by the Commonwealth Fund has come up with a very different perspective on what can and should be accomplished over the next five years.
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Despite pressing budget concerns that have limited their discretion and sometimes led to cuts in existing programs, many states still have managed to implement innovative strategies, stretching health care dollars by using a portion of state money to leverage private, federal, and additional states funds, according to a state survey conducted by the Economic and Social Research Institute for the Commonwealth Fund.
