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The Medicare Conditions of Participation require hospitals to give patients a choice of post-acute providers, but that doesn’t mean that case managers shouldn’t give them the information they need to make informed choices.
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Before you can give patients the information they need to make a good decision, you need to know something about the facilities on the list you give the patients.
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Many families spend more time and energy researching the best microwave oven to buy than they spend choosing a post-acute facility for their loved ones
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The Centers for Medicare & Medicaid Services has made a one-time offer to hospitals to settle pending appeals of patient status claim denials for 68% of the net payable amount.
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Home care is an important intervention to consider for virtually every patient you discharge to home. By using the strategies discussed above, you can increase your percentage of patients going home with this important service. Remember to assess every patient on admission and to reassess every patient daily.
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There are two angles of attack to cutting catheter-associated urinary tract infection (CAUTI) rates by 25%, and the harder approach involves changing provider behavior.
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There's little doubt that as health care reform rolls out and all payers tighten their reimbursement, hospitals are going to depend more and more on case managers to help them ensure that patients receive the appropriate services in an efficient manner and safely move to the next level of care.
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If you're not already doing it, you need to start reviewing the cases of your patients receiving Medicaid benefits as vigorously as you do those of Medicare patients.
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In 2004, as talk of health care reform escalated, North Oaks Health System appointed a multidisciplinary process improvement team to determine what changes the hospital needed to make to prepare for where health care was going in the future.
