The 2020 IPPS final rule is out, and CMS has opted not to allow organizations to code homelessness as a complication or comorbidity (CC) under ICD-10-CM code Z59.0.
The U.S. healthcare system wastes some $760 billion to $935 billion dollars each year, says a recent study published in the Journal of the American Medical Association, and between $27.2 billion and $78.2 billion of that total is the result of failures in care coordination.
Four years after they were proposed, CMS has finalized a series of discharge planning changes that went into effect on October 29. The final rule, called Revisions to Discharge Planning Requirements [CMS-3317-F], imposes a number of new requirements—ranging from how to notify patients about their choice in postacute providers to prioritizing patient preferences when developing discharge plans and treatment goals.
Emerging literature recommends adding social isolation to the social determinants of health, particularly for older adults. Social factors, inclusive of education, race, social supports, and poverty, account for more than 30% of total deaths in the U.S. annually.
To prepare for natural disasters such as hurricanes, community case managers must reach out to and support their patients who are elderly, disabled, or otherwise at risk. Disaster preparation is a huge endeavor for case managers.
This spring, CMS changed the scope of work for their Beneficiary and Family Centered Care Quality Improvement Organizations (BFCC-QIO) Livanta and Kepro, which became effective June 8. The QIOs’ responsibilities were narrowed to focus primarily on discharge appeals, quality complaints, and real-time advocacy for Medicare patients and families.
While the Violence Prevention Program at Johns Hopkins addresses a very specific population, many of the lessons learned can be applied to almost any patient who is hesitant to accept resources. Included in this article are some of the program’s tips and strategies that you can apply to some of your more challenging cases.
A June report by Kaiser Permanente found that not only do Americans believe that having social needs met—such as housing, food, and social support—is crucial to good health, but 68% of those surveyed reported that they had at least one social need unmet in the last year, and more than 25% of them said that unmet social need affected their health.
A case manager for the Johns Hopkins Hospital-Based Violence Intervention Program in Baltimore, Leonard Spain works with victims of violence, often gunshots and stabbings, presenting a host of special challenges.
Stephanie, a home care nurse case manager, follows patients with repeated readmissions, stabilizes them in the community, and prevents the readmissions from continuing. But with record-breaking temperatures approaching, Stephanie knows that helping her patients avoid readmission will be more challenging than usual.
