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As hospital discharge planners and case managers struggle to place patients with complex care needs in skilled nursing facility (SNF) beds amidst the challenges of the prospective payment system (PPS), many are keeping their heads above water with a mix of timely planning, community collaboration, and creative thinking.
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Hospital case managers routinely face what I call the Bermuda Triangle of case management ethics. The top of the triangle is the clinical concern, encompassing the medical and treatment needs of the patient. On the right are the financial concerns, and on the left are the legal and ethical issues. In the middle of this triangle is the patient.
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When the administration at Davis Memorial Hospital in Elkins, WV, redesigned its case management department, improving reimbursement for emergency department (ED) patients and same-day-surgery patients was a major goal.
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Before the case management staff at Davis Memorial Hospital in Elkins, WV, went live with its newly designed case management plan, staff worked hard to sell the new arrangement to hospital staff and attending physicians.
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Case managers are in an excellent position to help their hospitals balance both the clinical and the financial sides of patient care, asserts Teresa C. Fugate, RN, BBA, CPHQ, CCM.
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In these times of dwindling health care reimbursement, there's no phrase more significant to managers - and their bosses - than "denial management."
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Today's case managers need to understand outcomes and track them in order to prove that their interventions have value, says Mary Jane McKendry, RN, CCM, MBA, director of education, training, and consulting for McKesson and president-elect of the Case Management Society of New England in Hampstead, NH.
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With payers sharpening their pencils and refusing to pay for what they deem to be unnecessary hospital stays, case managers need more than ever to help their hospital balance the clinical and financial aspects of health care.
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Comply with these stroke evaluation time targets recommended by the Bethesda, MD-based National Institute of Neurological Diseases and Stroke.
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At Davis Memorial Hospital, case managers work 10-hour shifts, four days a week, often choosing their own days off.
