Assigning the correct patient status is important not only to ensure that the hospital gets accurate payment for a patient stay, but also to ensure that the patient receives access to the postacute benefits to which he or she is entitled.
Observation services are an ongoing point of confusion for hospitals and patients, many of whom have become fearful of out-of-pocket costs and SNF coverage eligibility associated with outpatient observation services. Developing a workflow to comply with the Notice of Observation Treatment and Implication for Care Eligibility (NOTICE) Act and the Medicare Outpatient Observation Notice (MOON) is essential and is intended to help hospitals ease patients' concerns by clearing up the implications of observation.
There's good news and bad news on the 2-midnight rule front. The good news: CMS has put short-stay inpatient audits related to the 2-midnight rule on hold as of May 4. The bad news: This isn't a free pass, and it isn't going to last.
One of the more challenging aspects of a case manager's job is helping to ensure a patient successfully transfers from the hospital to the next level of care. Under a set of proposed revisions to Medicare's Conditions of Participation (CoP) announced in November 2015.
Discharge planning has become more important in recent years. Not only is the government putting new focus on ensuring hospitals are helping patients to move to the next level of care more efficiently, but research shows that patients are safer and less likely to return to the hospital if these transitions are well managed.
Discharge planning has long been a challenge for organizations, but proposed revisions to Medicare'sConditions of Participation announced in November 2015 may make the process even more difficult.
Q: I am a certified case manager working in an acute care hospital. As part of our job requirements, when working in the emergency room (ER), we are asked to problem solve throughout the day. We often get requests for information on patients seen in the ER who have since been discharged.
The Commission for Case Manager Certification and the National Association of Social Workers entered an agreement to offer more social workers a chance at earning the Certified Case Manager® credential.
The Commission for Case Manager Certification and the National Association of Social Workers entered an agreement to offer more social workers a chance at earning the Certified Case Manager® credential.
