RN010101

Hi again, any thoughts?

Hello! I was hoping for some help. What do you do or what do you say in cases where: -the patient does not want to be transferred to LTAC? I've heard many patient say "why can't I stay here? Why do I have to go to an LTAC? and -the patient does not want to be transferred to a SNF, when it is the most appropriate discharge plan (no LTAC criteria, needs rehab, etc.)? Also, any advice on how to deal with patient/family members who take a while to decide on which facility they would like placement on. I've had a case where a patient stayed in the hospital unnecessarily since the family would not decide on which SNF. Thanks in advance!

Thank you all for the great advice. I'm a new CM, and I'm learning a lot through this thread.

Thanks so much for the advice MBARNBSN! I've been struggling since I'm new to CM. The UM, discharge planning, obs vs inpt, MD and staff coordination, etc. has just been overwhelming. I feel there is not enough time in a day to finish everything. I'm trying my best to learn the skills of a CM and trying to train myself to have the mindset of a CM. Thanks again for the great advice!

Hi everyone. I'm a new case manager. Any advice on how to fit all this in a working day? I've been working 12 hour days 5 days a week instead of 8 hour days. Any advice on how I can prioritize? Do you assess all the patients? If not, how do you determine if a patient needs an assessment? Is working overtime everyday the norm?

Thank you everyone for the great advice! I'll be using all of your suggestions ?.

Yea, you're right lol!

Hi d'cm, Thanks for the reply! Any advice on how to give this info without being yelled at? Lol!

Hi everyone! I'm a new hospital CM. I recently had a case where the insurance company denied the INPT status and approved Obs. They provided the peer to peer info. So I called the MD and informed him. Needles to say, he wasn't pleased that I was asking for a peer to peer. How do you handle these types of situations? Do you normally inform the MD that the insurance denied and that a peer to peer is offered?

[COLOR=#666666]Thanks MBARNBSN! I appreciate your advice and feedback. I am not a new grad, but still have trouble speaking confidently because of my personality. It is a skill that I am trying to cultivate, and hopefully I will achieve it soon.

Hi everyone! I'm new in Case Management, and I was hoping for some advice on how you approach and speak to MDs in regards to the patients not meeting criteria. I have heard that many MDs don't like to hear the word "criteria" so I was curious on how CM nurses get their point across that the patient may need to be either discharged or admitted for inpatient care and/or if they are already inpatient, how to communicate that the patient needs to be discharged? Thanks!

I'm so sorry that happened to you. I do agree with the other posters that you dodged a bullet.

Congrats! ?

Hi mclennan, Thank you for your reply. Can you tell me more about your typical day as a case manager? Thanks!

Hi Been there,done that, Thank you for your reply. My background is mainly QA. I tried to also apply for insurance jobs, but didn't receive any calls (presumably due to my lack of Case Management experience). I'm just not sure what to do, since I've been looking for a CM position for a long time. Thanks to God, a hospital hired me, but now I am scared if I can physically handle it. How much physical activity is there in CM? Is it possible to sit once in a while?