Case Management in nursing

BeachsideRN, ASN · Mar 13, 2014

Curious also. Following this thread.

nurseprnRN, BSN, RN · Mar 13, 2014

What exactly is case management and a case manager? What is an example of both?

Homework?

Go to the yellow bar at the top of the page, click Specialties, and go to the Case Management forum. Lots of info there.

BeachsideRN, ASN · Mar 13, 2014

Do you know how to get to specialties from the mobile app? And, fwiw, nit homework fir me just curious about different prospective specialties. Nit sure about OP though.

Bluebell. · Mar 13, 2014

Not homework. Just trying to understand the concept instead of memorizing the definition. I'll try to look in that section.

classicdame, MSN, EdD · Mar 13, 2014

In my facility the case manager is in charge of determining appropriate utilization of all resoures. For instance, CMS has a 2-midnight rule. If the MD does not think the patient will be here for 2 midnights, then the patient is not eligible for admit but may be eligible for observation. To the floor nurse, there is no difference in care. To the Case Manager the difference is dollars we can bill to CMS. Once something changes in the patient's situation we can go to full admit status. The Case Manager determines what changes make the patient eligible for a change in status. This is one scenario. They also work with our social workers to get the patient what is needed after discharge, like a referral to MD, wheelchair, etc.

nurseprnRN, BSN, RN · Mar 13, 2014

Some "case management" departments in some hospitals are really discharge planning only; this does not fit the definition of CM and that job description would not allow you to sit the CCM examination. CM affects the direction of medical care by coordinating care and resources, most broadly. This often includes discharge planning, but there's a lot more to it, as classicdame notes above. There are bazillions of non-hospital nurse case manager careers, too; you will learn about those in the CM forum, too. Check out CMSA for more information; join the local chapter.

nursegreene · Mar 13, 2014

This is the third thread that someone has answered a question with " homework?"

First, isn't this the place to ask questions about nursing? Second, who cares if it is homework? The op is still looking for the knowledge.

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nursegreene · Mar 13, 2014

Meant to say....Third thread I've read today.

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classicdame, MSN, EdD · Mar 13, 2014

I have a friend who is a certified case manager and works for an insurance company. Her job is to make sure the insured (worker's compensation) is getting the treatment they need and is utilizing resources appropriately. Requires communication with MDs, faciilities, and insured.

nynursey_ · Mar 13, 2014

This is the third thread that someone has answered a question with " homework?" First isn't this the place to ask questions about nursing? Second, who cares if it is homework? The op is still looking for the knowledge. Sent from my iPhone using allnurses.com[/quote']
I was just thinking the same thing. It's disappointing to see the skepticism.

nynursey_ · Mar 13, 2014

Some "case management" departments in some hospitals are really discharge planning only; this does not fit the definition of CM and that job description would not allow you to sit the CCM examination. CM affects the direction of medical care by coordinating care and resources most broadly. This often includes discharge planning, but there's a lot more to it, as classicdame notes above. There are bazillions of non-hospital nurse case manager careers, too; you will learn about those in the CM forum, too. Check out CMSA for more information; join the local chapter.[/quote']
Of note, my hospital makes a delineation between case management and discharge planning. They are two separate nursing titles.