Social determinants of health are social factors, such as homelessness, illiteracy, a history of childhood trauma, and joblessness or underemployment, that can affect a person’s health. Coding for these factors is important because CMS officials now use some of them to adjust quality measures for patients who are dual-eligible for Medicare and Medicaid, and coding these factors may help shape future health policy.
Two recent high-profile celebrity suicides and news from the Centers for Disease Control and Prevention (CDC) that suicide rates are on the rise across the country have prompted some healthcare professionals to look more closely at suicide prevention and whether more can be done to help individuals struggling with mental illness.
Case management is a tactical and strategic profession governed by ever-changing regulations. Staying current with regulations is not something a case management leader can do casually or occasionally. The process requires thoughtfulness, broad thinking, and the ability to educate staff and to implement and audit process changes as they relate to new regulations.
A case manager on a busy medical-surgical unit is facing an end-of-life case. The patient is an immigrant from Chile with limited Medicaid. As the hospital stay continues and his clinical condition worsens, it becomes clear that he has little time left. How can the case manager work with the patient and family to fulfill the patient’s end-of-life wishes?