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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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Case Management Weekly

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 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...