BahaMamamaRN

Hello everyone, I have been a nurse for 24 years. I obtained a MSN and CCM in 2014 and I am having a difficult time obtaining a leadership role. The last 8 years I have been a hospital case manager. In this role I did utilization review and case management activities related to decreasing readmissions and care coordination. I have past experience in long term care as a MDS Nurse and I coordinated the care conferences. Additionally, I worked as weekend shift supervisor 12 hour shifts for about a year for a group of nursing homes. Well, since I have not landed a manager of case management position, I am considering getting back into long term care. I have an interview at a facility tomorrow for an ADON position. I would like to know the drawbacks of this role. This facility does not utilize agency. The regional director of nursing is covering the building now and the new DON starts soon. I did speak with the new DON on the telephone, she has been a DON for 15+ years so I think she would be a great person to learn from. Lastly, the medicare.gov rating at the nursing home is 2/5. With 5 deficiencies on the last survey. I asked why the last DON left and was told poor work ethic. They told me they were seeking a new management team that could build the team up and show some employee appreciation. Currently, I have a transitional care nursing role at the hospital working for a group of doctors and I do not fill challenged. Thank you in advance for your comments

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I have been a case manager for 7 years. I started in LTAC, then acute care and now insurance. Each setting provided a lot of learning opportunity and growth. Of the three I think I like insurance best. I love being a case manager. I too will likely work in this field until I retire. Sent from my iPhone using Tapatalk

I just recently passed the exam for the first one mentioned above CCM through the commission for case management certification. Often I see positions for preference for the CCM in the midwest area. I also just recently completed my RN to BSN program through Indiana Wesleyan University. They have online and onsite programs. I did the onsite program for my BSN. I am currently in the online MSN program there. If you have additional questions about my experience at IWU send me a private message.

Lol at your reference to "schmoozing the case managers on the floor" laughing but good advice for those seeking a position. I find everyone we have hired are from CM recommending floor nurses or other known experienced case managers who knows someone experienced or not. Good luck in your search.

Thanks for the link

Also, I have been a CM for 3.5 years and I am just about to start studing for the CCM after I finish my BSN in Nov, 2011. I woud say dont try to get a certificate right now. Maybe get a reccomend book for the CCM exam and become familiar with the terminology and process to help in your interviewing skills.

Most of the case manager at our LTACH were those hired directly from the floor without any prior expereince (including myself). So, I would let the director of case management know of your interest in getting into the field, so that he/she can keep you in mind for future availble oppurtunities. Also watch the job board at your place of employment our positions are usually filled fast. Good luck to you.

Our social workers do the discharge planning piece. The nurses do the case management aspect. I feel there is a lot of bargaining with insurance companies to get the patient more time. I think a year of floor nursing with your history of working in socail work would suffice. Just to give yourself some time to understanding the medical aspect of the job. Often, I give the physicans the anticipated plan for discharge and what can be manged at a lower level of care. It's up to you but I think you would find it beneficial to have some floor experience prior to taking fulltime role as an RN Case Manager.

Because of the fast paced nature of the job, orientation at our facility is ongoing, kinda ask questions as you go. The inital interest of teaching the new person is how to do insurance reviews and lead care conference. That occurs during the first two weeks. Then it is pretty much seek out help when something comes up. I work at an LTACH. Some of the things that does not come up during the inital training would be filling out C9 for workers comp, Medicare appeal process, resources for people who have no insurance. The person that I oriented most recently is doing well. He calls me with questions if I can't help on the phone, I go down to his office to reccomend the best way to handle things that come up. Hang in there, it will get better each week. Good luck to you in your new position. Stephanie

To qualify for home O2. I usually have Respiratory Therapy document a room air Sat For a new home Bipap order that gets difficult for me(Ltac setting) because the pt needs to have an actual sleep study not just a overnight pulse oximetry reading. We do not have a sleep center @ our facility. Most of the time the pt's have had this done before and it does not have to be recent. So, I talk to the pt and find out the facility where they had this and get them to fax the info to the home o2 company. Once, I had to have the pt schedule the sleep study outpt before he could qualify to receive the bipap machine at home. The home O2 company would not budge even though we had the orders for settings we used in the hospital. I hope that helps a little.

Try Drake Center. It is a LTAC( Long Term Acute Care) hospital. Go to Health Alliance website select Drake as the location then start the search. The patient ratios are not as high as it would be in a traditional SNF. good luck in your search.

Medicare competitive bidding is suppose to start on July 1st 2008. Are any the case managers here involved in discharge planning? Some of my favorite vendors did not get the contract from Medicare, bummer. I like it now, I call one company and that company takes care of of all DME equipment. With competitive bidding we will have to call several different companies to get the pt's supplies @ d/c time. I guess it will work out we will eventually learn who to call for what. It just seems this will be a little crazy at first.

We do Interquall reviews weekly our Census is usually around 28 for two Nurse Case Managers. We coordinate care conference weekly, provide families and pt w/ weekly updates. Call insurance for continued stay. Luckily I have a social worker who orders equipment and facilitates the discharge ordering home health and IV therapy for home .She also calls and schedules the patients follow up appointments. It is constant but it sounds like you have your hands full with helping out on the floor and performing other nursing duties. I'd look for another job who valued my case management expertise better.

The chart review position may open the door for you to later apply for a CM position @ the hopsital at a later date. I was off the unit for about two years working as the patient advocate, handling complaints and the transition into CM has been smooth for me. I was able to get to know the people in the department they often had to eplain to me the insurance reviews and the discharge process b/c pt complained all the time about being d/c'd. By the time I switiched to CM I felt I understiood the job Good luck to you.