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Sneak Peak: Issuing patient notifications to difficult patients and their families

Case Management Weekly, January 4, 2012

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Greg, 80, admitted to the hospital with community acquired pneumonia, refuses to sign the Important Message from Medicare (IM). Therefore, the admitting clerk and a witness cosign the IM, verifying Greg’s refusal to sign. The next day, the case manager asks permission to speak with Greg’s daughter because Greg is reluctant to say anything, and Greg consents.

Barriers to discharge
After the first few days of intensive care and treatment, it is apparent that Greg needs some rehabilitation before returning home, and the case manager discusses local facilities with Greg. He agrees with the plan, and the case manager contacts the facility. The case manager presents the IM again, informing the patient that Medicare rules require that patients be notified of their rights before discharge. Greg again refuses to sign the IM, which is witnessed and signed by staff.

This article is adapted from an article in the December 2011 Case Management Monthly.

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