You know the drill: rally for improved documentation practices at your facility, train everyone on proper documentation procedures, and become foiled by inexplicably incomplete records, illegible handwriting, and records that are lost in transition. But you’re not alone. This is exactly what case managers at Cleveland Clinic dealt with.     Read More »

Despite the effect the economic downturn is having on the national job market, hospitals still face a daunting challenge in retaining quality case managers. Some of the reasons for case manager turnover are the high stress of the profession, long hours, and the difficulty of transitioning from nursing or social work into case management.   Read More »

ED overcrowding is a problem almost every hospital faces. Many patients inappropriately come to the ED for nonurgent issues, but, by law, the ED is required to treat everyone. This puts hospitals in the difficult situation of having to care for all patients safely and efficiently.   Read More »

The United States has difficulty penalizing or closing unsafe hospitals because it lacks a single federal agency in charge of overseeing them, says The New York Times. The Joint Commission sets basic safety standards, but has only 1,000 employees while it accredits more than 17,000 hospitals, nursing homes, and assisted-living facilities. Additionally, CMS’ new initiative to stop reimbursement for preventable errors, The Times argues, will not make enough...  Read More »

As emergency departments are filled to capacity with patients who have no insurance or can’t afford care, fewer patients are visiting the hospital who do have the ability to pay. Because of the worsening economy, patients are opting to postpone non-emergency surgeries such as knee replacement or weight-loss surgery, according to The New York Times. These types of surgeries are normally the most lucrative for hospitals, but patients fear costly co-payments...  Read More »

If your case management program is like most, it focuses mainly on utilization review and discharge planning. Stefani Daniels, RN, MSNA, CMAC, ACM, says many case managers are getting bogged down by these duties and losing focus of what case management is really about: patient advocacy.   Read More »

When New Hanover Regional Medical Center (NHRMC) in Wilmington, NC, wanted to decrease LOS, increase Medicare compliance, and improve its bottom line, it needed a place to start. The case management department was the perfect spot. NHRMC implemented an initiative to make its case management department more efficient and effective. The changes resulted in a 0.28 difference in Medicare LOS, increased bed availability by 3,732 in 2007, and saved the organization...  Read More »

Today, hospitals are facing many challenges: Shrinking payer sources, increasing charity care, mounting bad debt, and the reduction of Medicare payments due to new initiatives—including recovery audit contractors and present on admission—give hospitals greater moti-vation to be on top of their game.   Read More »

St. Luke’s Episcopal Hospital in Houston had several problems in its ICU: LOS rates had risen, beds were being used inappropriately, bed availability was scarce, and multidisciplinary rounds were inconsistent. To turn things around, the unit took a collaborative approach to discharge planning.   Read More »

CMS announced last week that the 2009 monthly premium for Medicare Part B will stay at $96.40, the same as it was in 2008. It’s the first year since 2000 there was no increase in the standard premium from the previous year. According to CMS, the standard Medicare Part B premium is set to cover one-fourth of the average cost of medical services incurred by beneficiaries over age 65. Even though medical expenses for the beneficiaries are expected to increase...  Read More »