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Case Management Weekly
Case Management Weekly is a free e-mail newsletter that offers news, resources, and Q&As to help case managers from all settings find ways to enhance quality and reduce legal and compliance risks.
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Issue 2, January 11, 2012
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Sneak Peek: How a patient tracking system is improving case management
Earlier last decade, when patients came into the ED at Christiana Care Health System in Newark, DE...
Issue 49, November 5, 2012
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Notice: Your subscription will be changing next week!
Case Management Weekly will soon be replaced by Nurse Leader Insider. -
Notice: Your subscription will be changing next week!
Case Management Weekly will soon be replaced by Nurse Leader Insider. -
Sneak peek: Exploit benefits of text messaging while preventing privacy breaches
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Sneak peek: Appropriate response when staff acknowledge mistakes helps ensure patient safety
You're reviewing a case file and discover that a patient's recent readmission is due to a... -
Mentor moment: Educating the medical staff
“It’s like herding cats. ”This is the description hospital staff give when... -
News: New Orleans site of 2013 CMSA conference
The Case Management Society of America (CMSA) will host its 23rd Annual Conference & Expo June... -
Case management Q&A
Q. What are the levels of care?
Issue 48, November 28, 2012
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Mentor moment: Disclosing financial interests to patients
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News: Nashville site of 2013 ACDIS conference
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Case management Q&A
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Issue 47, November 21, 2012
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Sneak peek: Readmission penalties expected to affect two-thirds of U.S. hospitals
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Mentor moment: Planning for discharge
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News: Primary care physicians to receive higher Medicaid payments
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Case management Q&A
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Case management Q&A
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Issue 46, November 14, 2012
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Sneak peek: One simple question about patients’ benefits coverage can eliminate big headaches
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Mentor moment: Anticipated impact of ICD-10 on CDI programs
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News: Medicare Advantage enrollment on the rise
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Case management Q&A
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Issue 45, October 7, 2012
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Sneak peek: More must be done to reduce frequency of medication-related readmissions
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Mentor moment: Skills of the effective case manager
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News: 91 face charges in $429 million Medicare fraud case
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Case management Q&A
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Issue 44, October 31, 2012
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Sneak peek: Next month in Case Management Monthly
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Mentor moment: Predicting the expected date of discharge
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News: More trauma care spending doesn’t raise survival rates
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Case management Q&A
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Issue 43, October 24, 2012
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Sneak peek: ACMA credential focuses on hospital challenges
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Mentor moment: Revenue cycle management
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News: CMS announces redesign of Medicare website
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Case management Q&A
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Issue 42, October 17, 2012
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Sneak peek: Strategies to help staff understand, review research
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Mentor moment: Case management and clinical documentation improvement
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News: IHI seminar to focus on benefits of patient-centered care
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Case management Q&A
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Issue 41, October 10, 2012
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Sneak peek: Evidence-based practices can help improve, enhance case management skills
A trend in recent years encourages clinicians to adopt evidence-based practices to improve clinical... -
Mentor moment: How to approach busy physicians
If you were trying to do five things at once and were already 10 minutes late for an appointment... -
News: Medicare beneficiaries save $4.1 billion on prescription drugs
Nearly 5.4 million senior citizens and individuals with disabilities have saved more than $4.1... -
Case management Q&A
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Issue 40, October 3, 2012
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Sneak peek: This month in Case Management Monthly
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Mentor moment: Discharge planning and quality improvement
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News: Settlement bans Accretive Health in Minnesota
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Tip: Query forms bridge the gap when coders, physicians speak different languages
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Issue 39, September 26, 2012
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Sneak peek: Teach patients about COPD, smoking cessation services
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Mentor moment: Discharge planning in a changing healthcare environment
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News: Public, private groups form partnership to prevent healthcare fraud
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Case management Q&A
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Issue 38, September 19, 2012
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Sneak peek: Managing COPD to avoid readmissions
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Mentor moment: Caregivers and transitions
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Mentor moment: Caregivers and transitions
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News: Initiative will help states improve healthcare systems
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Case management Q&A
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Issue 37, September 12, 2012
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Sneak peek: Observation stays may hurt some patients
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Mentor moment: Engage patients, families in discharge planning
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News: Website enhancements facilitate facility comparison
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Issue 36, September 5, 2012
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Sneak peek: Focus care on patients and families to improve quality
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Mentor moment: Collecting discharge planning data
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Save the date: CDI Week is September 16?22
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Case management Q&A
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Issue 35, August 29, 2012
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Sneak peek: Next month in Case Management Monthly
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Mentor moment: Denial management
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News: Make plans for Case Management Week observance
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Case management Q&A
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Issue 34, August 22, 2012
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Sneak peek: CDI and case management a vital collaboration
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Mentor moment: Reopening or appeal?
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News: ACMA to host annual leadership conference
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Case Management Q&A
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Issue 33, August 15, 2012
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Sneak peek: Whip your UR committee into shape
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Mentor moment: The benefits of having a physician advisor
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News: CMS awards loan for Utah health insurance CO-OP
CMS has awarded Aarches Community Health Care in Utah an $85.4 million loan to launch a new... -
Case management Q&A
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Issue 32, August 8, 2012
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Sneak peek: Obesity and readmission a growing problem
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Mentor moment: The role of physician advisors
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News: 88 new accountable care organizations to serve 1.2 million
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Case Management Q&A
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Issue 31, August 1, 2012
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Sneak peek: This month in Case Management Monthly
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Mentor moment: Engaging consumers is a necessity
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News: CMS announces proposed home health changes for 2013
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Tip: Training your physician advisor
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Issue 30, July 25, 2012
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Sneak peek: Sample documentation clarification request
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Mentor moment: If at first you don?t? succeed, try again
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News: Health insurance rebates to total $1 billion
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Case management Q&A
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Issue 29, July 18, 2012
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Sneak peek: Preparation strategies for certification exam success
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Mentor moment: Put patients in the driver?s seat
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News: 14.3 million Medicare beneficiaries receive preventive services
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Tip: Long list provides many reasons for incorrect insurance information
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Issue 28, July 11, 2012
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Sneak peek: Engage case managers in document review process
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Mentor moment: Understanding the essence of transitions of care
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News: Primary care initiative aims to provide quality care at lower cost
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Case management Q&A
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Issue 27, July 4, 2012
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Sneak peek: Is certification right for you? Factors to consider when deciding
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Mentor moment: Seeing RED
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News: Initiative supports home, community-based services
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Case management Q&A
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Issue 26, June 27, 2012
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Sneak peek: Next month in Case Management Monthly
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Mentor moment: Discharge planning and the revenue cycle
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News: ACMA announces 2012 social work case management fellow
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Case management Q&A
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Issue 25, June 20, 2012
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Sneak peek: Physician advisor job description
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Mentor moment: How to implement a readmission reduction program
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News: Changes on horizon for home healthcare eligibility
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Tip: Understand the discharge planning process
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Issue 24, June 13, 2012
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Sneak peek: Ensure the right fit when hiring a physician advisor
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Mentor moment: Can a case management team approach benefit your organization?
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News: Wendy DeVreugd to discuss case management mentoring at CMSA conference
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Tip: Helping patients by understanding how they learn
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Issue 23, June 6, 2012
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Sneak peek: Understand home health rules for better care
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Mentor moment: What to do when you have too much to do and too little time
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News: UHC web conference to focus on coordinating care, patient flow
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Tip: Encourage physician advisors to mentor their peers
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Issue 22, May 30, 2012
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Sneak peek: Team approach benefits Maine healthcare organization
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Mentor moment: Why don't physicians listen or understand?
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News: ACMA seeks presentation proposals for 2013 conference
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Case management Q&A
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Issue 21, May 23, 2012
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Sneak peek: Next month in Case Management Monthly
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Mentor moment: Who is tracking Medicare benefit days?
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News: Providers share Recovery Audit Program experiences
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Case Management Q&A
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Issue 20, May 16, 2012
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Sneak Peek: Effective planning can relieve audit fatigue
Case managers are already familiar with the Medicare Recovery Audit Program. In January, however... -
Mentor Moment: Understand home health rules for better care
For many patients, home health services can mean the difference between a successful recovery and a... -
News: Hospital ED wait times differ significantly
Hospital leaders who think their ED patients' wait times compare well with their competitors should... -
Case Management Q&A
Q. Medicare beneficiaries sometimes have information about discharge planning from CMS. What...
Issue 19, May 9, 2012
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Sneak Peek: Avoid sticky legal issues during discharge
Making sure patients are prepared for discharge can be a tricky process. When certain laws are... -
Mentor Moment: Patient-centered care redistributes responsibility
It was a wonderful and rare accomplishment. In 2008, a 23-year-old woman with severe cystic... -
News: CMS issues IPPS proposed rule for FY 2013
Inpatient acute care hospitals could see a 2.3% increase in payment rates under the fiscal year...
Issue 18, May 2, 2012
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Sneak Peek: Barrier reduction teams improve efficiency at New York-Presbyterian
If your facility has factors that slow down the patient discharge process, your frontline staff... -
Mentor Moment: Helping CHF patients manage their condition and avoid unnecessary readmissions
When case managers are looking at patients who are frequently readmitted to their facility within... -
News: Preventing hospital readmissions takes a village
From Rockport to Yakima and from Detroit to El Paso, 30 community-based organizations (CBO) are... -
Tip: Appeal to key decision-makers when advocating for transitions programs
Beginning strategically, it is important to determine what your organization hopes to accomplish...
Issue 17, April 25, 2012
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Mentor Moment: How iPads improve the patient experience
Since the first-generation iPad hit the market in 2010, physicians have embraced the gadget and... -
Sneak Peek: A (controversial) case for ending the marriage between UR and case management
Utilization review (UR) and case management are as traditional a team as peanut butter and jelly... -
News: CLABSI rates down 32%, says CDC
Twenty-one states posted decreases in central line-associated bloodstream infections (CLABSI) in... -
Tip: Effectively manage chronic illnesses to prevent readmissions
Healthcare professionals need to reframe their assumptions about preparing patients for self-care...
Issue 16, April 18, 2012
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Sneak Peek: Prepare a safe, timely discharge plan
By Rochelle Schiller, RN, MBA Discharge planning is all about having patients and families... -
Mentor Moment: Who is tracking Medicare benefit days?
Our seniors seem to be getting more chronically ill. These days, they don’t present to the... -
News: Poor care for terminal cancer patients widespread
In a study that surprised its researchers, National Cancer Institute-designated hospitals as well... -
Audio conference: Utilization Review 101: Meet Requirements and Maintain an Effective Committee
A utilization review (UR) committee is not only a government requirement; it’s your...
Issue 15, April 11, 2012
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Sneak Peek: Mastering the handoff: Tips to avoid dropping the ball
One of the riskiest times for a patient comes when they are leaving the hospital and heading home... -
Mentor Moment: HHS proposes one-year delay of ICD-10-CM/PCS
HHS released a proposed rule April 9 announcing a one-year delay of the implementation of... -
News: Advanced practice nurses battle on for autonomy
As advanced practice nurses gain ground in their battle for autonomy, the Missouri State Medical... -
Audio conference: Utilization Review 101: Meet Requirements and Maintain an Effective Committee
A utilization review (UR) committee is not only a government requirement; it’s your...
Issue 14, April 4, 2012
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Sneak Peek: Helping CHF patients manage their condition to avoid unnecessary readmissions
When case managers are looking at patients who are frequently readmitted to their facility within... -
Mentor Moment: 30-day readmissions rule under two-pronged attack
Five months before Medicare’s hospital readmission penalties take effect, two groups of... -
News: Don't take low nurse turnover rates for granted
The nursing shortage is over, and a survey published in the American Journal of Nursing shows that... -
Audio conference: Medical Necessity 2012: Case studies and top documentation risk areas
Medical necessity continues to gain national attention as Recovery Auditors scrutinize compliant...
Issue 13, March 28, 2012
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Sneak Peek: Reflecting on your 2011 case management program
By Wendy DeVreugd, RN, BSN, PHN, FNP, CCDS, MBA With a new year upon us, it is time for case... -
Mentor Moment: Recovery Auditors focus on renal, urinary tract infections
Recovery Auditor findings indicate that many patients with renal or urinary tract infections... -
News: More men entering nursing workforce
Men searching for employment as a result of the economic downturn are gravitating toward... -
Audio conference: Medical Necessity 2012: Case studies and top documentation risk areas
Medical necessity continues to gain national attention as recovery auditors scrutinize compliant...
Issue 12, March 21, 2012
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Sneak Peek: Case study: Preparing for an ACO
In December 2011, Detroit Medical Center (DMC) got word that it had been selected as one of only 32... -
Mentor Moment: EMTALA: Extend coverage to inpatients?
CMS wants to know what providers think. It released a proposed rule February 2 designed to clarify... -
News: MRSA meets its match in certified infection preventionists
Hospitals use dozens of practices to prevent hospital-acquired infections. However, those... -
Tip: Familiarize yourself with Medicaid bed hold policies
Discharge planners must be aware of nursing facility bed hold policies. Nursing home residents...
Issue 11, March 14, 2012
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Sneak Peek: Reduce medication errors to prevent readmissions
If you're looking to reduce your hospital's 30-day readmission rate, it's time to focus in on a... -
Mentor Moment: Mobile devices -- check 'em out with your privacy, security officer
Hospitals today are turning to mobile devices more than ever, and that comes with increased privacy... -
News: Most C. Diff infections start in healthcare facilities
The Centers for Disease Control and Prevention called on all providers, from nursing homes to... -
Tip: Understand the implications of patient compliance
The World Health Organization (WHO) estimates that as many as 50% of patients fail to take...
Issue 10, March 7, 2012
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Sneak Peek: Work with postacute care to reduce readmissions
So you've looked at your readmission data, and you've found a problem. One nursing home or SNF is... -
Mentor Moment: Medicare patients given fewer treatment options
More than one-third of Medicare patients who underwent a prostatectomy, and 90% who had elective... -
News: Kaiser Permanente ordered to halt denial of care
Kaiser Foundation Health Plan is illegally denying some of its California enrollees physical... -
Tip: Be sure the medical record contains all pertinent insurance information
Discharge planners generally are not involved in the registration process, during which patients...
Issue 9, February 29, 2012
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Sneak Peek: Planning for homecare can reduce avoidable readmissions
Case managers want their patients to leave the hospital with a successful transition to home or... -
Mentor Moment: Creating accountability for patient experience
This article appears in the February 2012 issue of HealthLeaders magazine. Any story that attempts... -
Specialty nursing certification linked to lower healthcare acquired infection rates
The challenges to infection control are great. Whether a patient develops a hospital acquired... -
Audio conference: Observation services: A case study approach to proper billing
CERTs, RACs, MACs and MICs are more active than ever in auditing the necessity of inpatient...
Issue 8, February 22, 2012
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Sneak Peek: Respect patient choice; ensure education on appropriate discharge options
By Wei Deborah Lee, RN, MSN, case manager Ms. W is admitted to a Kindred long-term acute care... -
Mentor Moment: Facing the care coordination challenge
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News: CMS reveals central line infection rates
CMS added the rates of central line-associated bloodstream infections, or CLABSIs, for specific... -
Audio conference: Readmission Reduction Program
Effective October 1, hospitals with high readmission rates may face a 1%, across-the-board cut in...
Issue 7, February 15, 2012
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Sneak Peek: Mentorship program gives boost to new case managers
New nurses just out of school often find themselves at work alongside veterans who have little... -
Mentor Moment: Emergency departments in 2012 - the fastest changing places in healthcare!
By Karen Zander RN, MS, CMAC, FAAN, principal and co-owner, The Center for Case Management This... -
News: Keeping readmission rates low with treatment guidelines
Low readmission rates are reaching a new level of importance, according to a February 8... -
Audio conference: Readmission Reduction Program
Effective October 1, hospitals with high readmission rates may face a 1%, across-the-board cut in...
Issue 6, February 8, 2012
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Sneak Peek: Effort underway to establish caseload benchmarks
Many case managers today feel like they're overburdened, but it may not be clear whether they're... -
Mentor Moment: Blanketed approach to seeking continued care for our patients
As case managers, you may often work directly with leaders of other departments. Check out this... -
News: Hospital to use RNs only in acute-care inpatient setting
Rochester General Health System will be replacing licensed practical nurses currently working... -
Audio conference: Readmission Reduction Program
Effective October 1, hospitals with high readmission rates may face a 1%, across-the-board cut in...
Issue 5, February 1, 2012
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Sneak Peek: Planning for homecare can reduce avoidable readmissions
Case managers want their patients to leave the hospital with a successful transition to home or... -
Mentor Moment: Overweight physicians display bias in obesity care
Doctors who are overweight or obese are less likely than physicians of normal weight to diagnose... -
News: Hospital takes on septicemia, saves 36 lives
Around Opelika, AL, a city of about 26,000 and an hour's drive from Montgomery, 36 people are alive... -
Tip: Consider HHA or post-acute level transfers
Discharge planners have the difficult task of being the messenger with respect to continued stay...
Issue 4, January 25, 2012
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Sneak Peek: Ring in the new year with quality resolutions
It's January. Time to ring in the new year and make some resolutions for 2012. Case managers have... -
Mentor Moment: Giving every patient the Beyoncé experience
The gossip mills have gone into overdrive since celebrity power couple Beyoncé and Jay-Z... -
News: Spectrum Health targets ED frequent fliers for primary care
A new program at Spectrum Health in Grand Rapids, MI is identifying "frequent fliers" at... -
Audio conference: Observation services: A guide to compliant level of care determinations
Understanding proper protocol for observation services creates confusion for many case managers...
Issue 3, January 18, 2012
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Sneak Peek: Four areas that break down physician relationships
Most case managers have had a spat with a physician at one time or another. Maybe a physician... -
Mentor Moment: Top 12 healthcare quality concerns in 2012
Which quality issues will provoke the most influential changes in healthcare in 2012? Or, which... -
News: Steward Health vs. nurse union fight an ugly harbinger
The union-management animosity at Holy Family Hospital in Methuen, MA, did not end with last July's... -
Audio conference: Observation services: A guide to compliant level of care determinations
Understanding proper protocol for observation services creates confusion for many case managers...
Issue 2, January 11, 2012
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Mentor Moment: CMS innovation advisors aim to improve quality of care
CMS has tapped 73 healthcare professionals for its innovation advisors program. Funded with $6... -
News: OIG to CMS, AHRQ: Help hospitals determine incident reports
The OIG found that hospital incident reporting systems only capture an estimated 14% of adverse... -
Tip: Understand Medicare options for late-day discharges
Discharge planners must consider late-day discharges. Many hospitals target a specific discharge...
Issue 1, January 4, 2012
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Sneak Peak: Issuing patient notifications to difficult patients and their families
Greg, 80, admitted to the hospital with community acquired pneumonia, refuses to sign the Important... -
Mentor Moment: Many providers unprepared for HIPAA audit
Most healthcare organizations charged with HIPAA compliance are not fully prepared for a privacy... -
News: Hospital develops program to combat nurse compassion fatigue
Barnes-Jewish Hospital in St. Louis has launched a successful program aimed at reducing nurse... -
Audio Conference: Condition Code 44: Best Practices for a Compliant Process
“Condition Code 44: Best Practices for a Compliant Process,” a January 10 HCPro audio...