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In addition to losing reimbursement when cases dont meet medical necessity, hospitals face additional lost revenue if the credentials of all personnel who provide care for patients are not up to date and the staff are performing interventions for which they are not licensed.
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When Bronson Methodist Hospital in Kalamazoo, MI, examined throughput in the emergency department, it determined that a culture change was needed to shorten wait time and make sure patients meet inpatient criteria and are admitted in the right status.
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Healthcare reform initiatives such as value-based purchasing and readmission reduction, and a growing emphasis on quality have heightened awareness of case management, says Toni Cesta, RN, PhD, FAAN, senior vice president, operational efficiency and capacity management at Lutheran Medical Center in Brooklyn, NY, and partner and consultant in Dallas-based Case Management Concepts.
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After years of being frustrated by the Centers for Medicare & Medicaid Services Recovery Audit Contractor (RAC) program and other audit programs, the hospital industry is taking action. Heres the latest:
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Your influenza vaccination campaign is coming into the public spotlight, and that means more pressure than ever on the logistics of administering and tracking those vaccinations.
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Butler County Health Care Center (BCHCC) in David City, NE, is small it has 25 beds serving a rural community of 2,500 but the administrators think big.
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Maybe in today's jaded world, $75,000 doesn't seem like a lot of money to win. But along with that little financial windfall won by University Hospital Case Medical Center in Cleveland in July, came a prestigious title: Winner of the American Hospital Association McKesson Quest for Quality award.
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When you talk to officials at The Joint Commission (TJC) about the annual sentinel event reports released in July, they are quick to tell you that the data represent just a portion of sentinel events in the country, because reporting them to the organization is voluntary.
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What do you do when something you desperately want to fix just won't be fixed?
