End-of-Life Care: Case Studies and Cost Efficiencies to Help Case Managers Determine Appropriate Levels of Care
Kathleen Bartholomew, RN, BS
Softcover: 122 pages
Includes 6 CCMC contact hours!
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End-of-life cases are among the most delicate and difficult for your case managers. This guide is designed to show you, step-by-step, how to tackle the clinical, financial, regulatory, contractual and social barriers to transitioning an end-of-life patient to the next appropriate level of care.
End-of-Life Care offers key resources and field-tested strategies. Moving end-of-life patients to the next appropriate level of care poses a huge challenge for case managers. Often, the biggest obstacle is trying to coordinate and communicate appropriate care goals with the clinicians, the patient and the patient's family—goals that will have a profound effect on your facility's bottom line. Your case managers will learn how to get physician and family buy-in to move end-of-life patients more efficiently to the next appropriate level of care and how to manage that care effectively.
When a patient's care is handled inappropriately, it can result in expensive, longer-than-necessary lengths of stay. You'll find out how your hospital can capitalize on the Medicare consultation rule - Section 512 of the Medicare reform law.
This book is widely read by:
- Directors of case management
- Directors of utilization review
- VPs of nursing/director of nursing
- Directors of social work/discharge planning
- Case managers
- VPs & directors of patient services/financial services
Inside End-of-Life Care you will find:
- Case studies: clinical, financial, regulatory, contractual and social barriers case managers encounter with end-of-life patients and concrete solutions to help overcome these barriers
- How to gain the physician's support for moving the patient to the next appropriate level of care. Use the sample conversations as a guide to help you set and communicate care goals with the patient's clinical staff.
- How to obtain the family's support for moving the patient to the next level of care. You'll get the tools and resources you need to help families overcome their perception that the hospital is "giving up" when a more appropriate level of care is identified—including sample conversations.
- Reimbursement/Medicare - The experts help you better understand reimbursement issues involving terminally ill patients and uncover new and under-utilized Medicare benefits that can benefit your facility's bottom line.
- Why a hospice may not take a patient: What issues you need to consider so you can seek alternative options when necessary. Checklist which lists all the qualifying diagnoses.
- The truth about end-of-life care, in settings such as palliative, hospice, and skilled nursing facilities. You'll be able to explain the realities about this care to physicians, patients and their families and dispel uncomforting myths. Includes clarification of the often-misunderstood four levels of hospice care.
- End-of-life care resources: There's an entire chapter devoted to resources for end-of-life cases, including associations, Web sites, and contact information
By applying the cost-efficiency recommendations presented here, the readers are able to:
- Maintain quality of care while closely monitoring utilization
- Decrease length of stay when possible
- Prevent readmissions to the hospital
- Prevent emergency room use
- Discharge patients to appropriate post-acute levels of care
Plus, all readers have the opportunity to earn 6 CCMCs. This activity has been pre-approved for 6.00 clock hours by the Commission for Case Manager Certification.
Jackie Birmingham, RN, MS, CMAC, vice president of professional services, CuraSpan, Inc. Jackie has over 20 years of experience in discharge planning and case management, and is a noted author and speaker. During this period Jackie advocated for the need to address care issues across the continuum while serving on a task force for the JCAHO. She also worked with the Health Care Financing Administration (HCFA) during the development of the guidelines for the implementation of the Social Security Act's section on discharge planning. Jackie is a past president of American Association for Continuity of Care, and was the year 2000 recipient of the Distinguished Case Manager of the Year for the Case Management Society of America (CMSA).
Pat Agius, RN, BS, A-CCC, CCM, CPHQ, is a consultant and advises on a variety of healthcare issues, including case management, hospice policies and procedures, new hospice programs, and hospices in transition. Prior to her career as a consultant, Pat was the director of performance improvement and interim director of operations at Saint Barnabas Hospice & Palliative Care Center in New Jersey.
With more than 17 years of experience, HCPro, Inc. is a leading provider of integrated information, education, training, and consulting products and services in the vital areas of healthcare regulation and compliance. The company's mission is to meet the specialized informational, advisory, and educational needs of the healthcare industry.
(information from the publisher)
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