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Skilled Nursing Facility Covered Care: A Refresher

Source: CMSA Today BY PAUL BORJA, RN, MBA, DNP, EdD, PhD, PHN, CCM, ACM-RN, CMAC, CMCN, CNML, CMGT-BC, CDONA, FACDONA, FAACM, AND TERESA CAPINA, RN, MSN Ever wondered if you or your loved ones qualify for skilled nursing facility (SNF) for rehabilitation or skilled nursing services? This article summarizes the requirements and important considerations. The […]

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Quality Connection: Leveraging Quality to Drive CM, UM & Revenue Cycle Outcomes

Source: CMSA Today BY PATRICIA RESNIK, MJ, MBA, FACHE, RRT, CPHQ, CHC, CHPC Introduction Quality, case management (CM) and utilization management (UM) are key to the financial success of a healthcare organization and play a vital role in the revenue cycle. This article focuses on important connections between quality, CM and UM, and the potential

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Driving Quality Improvement and Accreditation: The Vital Role of Care Management Programs and Care Managers

Source: CMSA Today BY LAWANNA GADDY, MSN, RN Quality improvement and accreditation are crucial in the healthcare continuum within a rapidly changing industry landscape. Care management programs and care managers ensure that healthcare delivery is not only effective but also maintains the desired levels of quality every time. This article delves into the essential role

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Integrating Quality Management into Case Management: A Reflective Review

Source: CMSA Today BY VIVIAN GREENWAY, PhD, MSA, BSN, RN, PAHM, CCM, AND SAJINI PAUL, MSN, RN When defining quality management, one can think of it as overseeing all activities and tasks that must be done to support a desired level of excellence. This includes the determination of quality policies, creating and implementing quality planning

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Promoting Quality Through Case Management Accreditation: 25 Years Later

Source: CMSA Today BY GARRY CARNEAL, JD, MA, AND MELANIE PRINCE, EdD, MSN, BSN, RN, NE-BC, CCM, FCM, FAAN During the rise of payer-sponsored case management programs in the 1990s, the Case Management Society of America (CMSA) and URAC (Utilization Review Accreditation Commission) began working together to help standardize key workflows associated with case management

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Transitions

Source: CMSA Today By Dr. Colleen Morley-Grabowski, DNP, RN, CCM, CMAC, CMCN, CMGT BC, ACM-RN, IQCI, FCM, FAACM As I transition from my role as president of the Case Management Society of America (CMSA) to becoming the immediate past president and chair of the CMSA Editorial Board, I am filled with a deep sense of

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Say “Hi” to Lily the Listening Bot: Share Some Feelings. Soon.

Source: CMSA Today BY GLENN P. ALLEN, MSOD I’ve spent nearly 40 years in learning and organization development. The past five years of my career have been spent working in healthcare. Rather than using space in this article to describe my motivations for developing Lily the Listener, and the professional experience that made it possible, I

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Innovation in Education Prepares Students to Care for Patients in Their Homes

Source: CMSA Today BY KATHY DRISCOLL, MSN, RN, NEA-BC, CCM, AND KATHRYN M. TART, EdD, MSN, RN The home setting is a vastly different environment from the hospital setting. While each space in a hospital is organized according to the needs of the patient and the treatment they receive from physicians, nurses and other staff, the home

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