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CMW Tip of the Week: Know when to deliver the Important Message from Medicare

Case Management Weekly, November 26, 2008

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This week’s tip, an “Ask the Expert” was submitted by Kimberly D. Mallory, MSN, RN, the director of case management at St. Mary's Medical Center in Huntington, WV,  and is answered by Diana Gregory, RNC, CCM, CPUM, ACM, case management supervisor at Martin Memorial Medical Center.

Q: Our case management department has the responsibility of distributing the Important Message from Medicare (IM) to patients at discharge. In order to remain compliant and not miss an unexpected discharge, we provide one to every Medicare patient on Monday, Wednesday, and Friday. This is time consuming and costly! We have discussed putting the responsibility on the discharge nurse but are receiving a tremendous push back. How do other facilities handle this one?

A: We have asked our case managers to try and focus only on those patients who might be discharged within the next two days when they distribute the IM on Monday, Wednesday, and Friday, instead of giving it to all Medicare patients. Even if the Medicare patient gets a discharge order and hasn't gotten a recent IM, they can be given one and have four hours to decide to appeal or not.

It is important to link the IM to the discharge planning process and not as a separate task. When case managers approach their patient to talk about setting them up for home health or to go to a skilled nursing facility, they should try giving the IM at the same time. We have also taught one of our clerical staff members to assist the case managers by scripting the approach to the patient as they give the IM. In that case, the case manager simply designates the patients who need to receive the IM.

Have a tip or tool you’d like to share? Or maybe a question for our experts? E-mail it to editor Julie McGinley at jmcginley@hcpro.com.Your thoughts could be featured in the next issue of Case Management Weekly!

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