candcase

You did not mention if the patient had been initially acute then the condition became comfort measures. Remember, InterQual provides a frame but other issues affect resource recovery for the spell of illness. You may have already max'd out the DRG and the reimbursement can be affected by contributing comorbids or those things which impact the weighted DRG. Does the facility may have a policy re: Lower level of care and if the patient is at a point where he can be moved to a hospice bed or a skilled nursing bed vs the patient is actively in transition and death is expected in hours? You can not make documentation exist for something that is not there but also you are part of a process and some facilities look at the cost of doing business with compassion where they can design it in. If the department has not taken a look at this as an identified group of patients, perhaps you have an opportunity to initiate a learning opportunity or a process improvement project?

I have had case management positions in hospitals, community based settings and in the insurance industry.You may want to inquire if they expect you to work with in the office setting for any length of time before you are allowed to telecomute. In my experience, they want to offer you time to learn the different product lines, the software and see how you fly before giving you a large amount of independance.This makes sense on both sides of the coin since the different employer contracts can have different pieces you can offer the member. It is great to be able to sound out your experiences with a caller with a supervisor who is skilled in this speciality. You don't say if you have begun to seek certification, but your employer will want to maintain some level of standard, so ask if they assist you with getting your certification, too. Good luck, I enjoy this level of skill in the nursing process.

First of all, you have great courage and are no quitter. Take a step back and see the bigger picture, which is you have a lot to share that will help some one else. If one door closes, truly, I know from my own life, another will open.There are people who will need your support in their life. Where ever you are, there are programs that will help you. I have seen a Community College program that provides bridging for LPNs to RNs. It was specific to an arrangement for VA LPNs but I think it exists for others. Maybe you could try to look at NYS Community College programs. The one I'm thinking of was at the Genesee Community College in Batavia, NY. PLease don't get discouraged, you've come so far.

We need good members of the profession, don't give up. You mention needing to meet a time line and that you like places with snow. I have 2 thoughts: Smaller rural areas have problems attracting folks and some facilities will host you to help you get started( win/win for both). In my part of WNY I think you could be employed quickly after you obtain a NYS lis. OR If you want, here you can work in a CNA position if you meet the requirements BUT you must not work and use your nurse skills at your level of preparation. Hard to do if you have the knowledge.