Case Manager Tools and Tips!

Do a through SOC with SBAR narrative. List phone numbers in narrative for quick reference. Insist that If you are to follow pt, then you get 1st crack at doing the SOC - otherwise you need to review POC on your own time and need to depend on someone else's assessment. List POC goals in SOC narrative so you have a check list for re-visits and can copy/paste to DC narrative with minimal extra work. Print your narrative.

Re: burnout. Look up your state's case law on Exempt status of home health clinicians. If applicable go to your county's lawyer referral service and have them write a letter stating that you are not exempt and they need to pay you OT for time over 8/40 hours.  They probably won't pay you LOL. But as long as you refuse to sign anything changing you to part time status (which they will try to bully you to do) then you can keep your benefits and work 8 hour days until they build a case to fire you (which they WILL do.)

If you really got gumption, start a conversation with your co-workers about why you make 1/4th - 1/5th of what your agency bills for your visits and start signing union cards. https://unitworkers.com/

On 9/9/2022 at 1:08 PM, GapRN said:

Do a through SOC with SBAR narrative. List phone numbers in narrative for quick reference. Insist that If you are to follow pt, then you get 1st crack at doing the SOC - otherwise you need to review POC on your own time and need to depend on someone else's assessment. List POC goals in SOC narrative so you have a check list for re-visits and can copy/paste to DC narrative with minimal extra work. Print your narrative.

Thank you so much for the response! Would you be able to share an example of including the goals in your SOC narrative? 

XX y/o F lives with ??? Who assists with ADLs. Referred for ST, & SN from MD office for additional speech therapy as ability improves.

We have previously seen Pt after she was hospitalized at SJRMC X/XX/XX- X/X/XX. Pt A&Ox2 & had PEG placed due to dysphagia &

hyponatremia w/ seizures & had sepsis secondary to UTI. Other Hx includes A, B, C, D, E, F,  & G. Pt developed a pressure ulcer from PEG during our last cert period but it had closed; It

has recurred and pt is going to O'connor wound clinic on wednesdays to manage it. current wound care is Every other day: Irrigate w/ NS,

pat dry. Apply periwound Triad, cover with hydrofera blue, gauze sponge, & secure with tape. Diet: bolus Jevity 1.5 275ml Q6H. SLP

notified case is open and ready for therapy

 (Son) (111) 111-111
(grandson) (222) 222-2222
PCP Dr. xx xxx   (333) 333-333    Fax:    (444) 444-444

Head to toe done: VSS except for rapid breathing, c/o unspecified pain, probably referring to abdominal pain which is very tender,

A&Ox2, lethargic. CG reports last 3 days small amounts of diarrhea & formed stool. Pt has abdominal tenderness & BS only present in RUQ. LCTA,

denies SOB but O2 sat drops rapidly w/out O2 NC & RR is 28. HS regular, PPP, cap refill < 3 sec, no edema. Incontinent to B&B; CG

previously educated and demonstrated effective bed bound/incontinence care. CG refused PEG site assessment because he just did wound

care, he reports stage 2 pressure ulcer with minimal purulent drainage. otherwise skin is CDI

Teaching done on diarrhea, pain mgmt, constipation mgmt & when to notify SN/MD.

POC includes: Medication MGMT, Pressure ulcer prevention, pain mgmt, wound care/weekly assessment, fall precautions, constipation