Hospital administrators often look at case managers when a patient stay exceeds targets. Length of stay is seen as case management’s responsibility—even though the factors that extend patient stays are often out of their control.
If your organization is part of a Medicare accountable care organization (ACO), changes may be on the horizon. CMS is proposing changes to the program that would require organizations to take on more financial risk and is giving it a new name, “Pathways to Success.”
A case manager works on a postacute transfer plan for a patient who is critically ill with sepsis and at risk for acute renal failure. Because the patient has a history of IV drug use, it is likely that long-term acute care hospitals will deny him admission.