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The complexities of case management

Case Management Weekly, January 15, 2008

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Case managers must advocate for the most optimal course of care for patients across the healthcare continuum. For catastrophic and complex patient conditions, this advocacy carries the responsibility of acquiring sufficient knowledge of all available options for the appropriate levels of care and treatment.

For example, the Complex Case in the January issue of Case Management Monthly features a 26-year-old college student who required case management assistance through a varied level of acute care settings, including short-term and long-term acute care (LTAC) hospitals during his complex illness.

The case managers were concerned that if he was sent to a skilled nursing facility, as his insurance company wanted, his progress would be delayed and inappropriate care decisions would be made for him. So his case managers advocated for continued care at an LTAC facility and were instrumental in negotiating and communicating with the insurer that an LTAC facility would be able to manage his complex conditions and optimize his acute but extended phase of recovery and plan of care.

To read more about this Complex Case, check out the January issue of Case Management Monthly.

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