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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.

2012 | 2011 | 2010 | 2009 | 2008 | 2007 | 2006 | 2005 | 2004

Issue 2, January 11, 2012

• 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

• 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

• 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

• 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

• 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

• 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

• 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

• 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

• 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

• 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

• 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

• 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

• 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

• 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

• 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

• 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

• 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

• 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

• 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

• 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

• 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

• 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

• 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

• 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

• 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

• 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

• 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

• 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

• 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

• 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

• 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

• 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

• 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

• 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

• 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

• 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

• 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

• 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

• 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

• 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

• 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

• 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

• 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

  Editor’s note: This article appears in the February 2012 issue of HealthLeaders...

• 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

• 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

• 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

• 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

• 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

• 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

• 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

• 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...