Discharge Planning/Rehospitalizations

(Live CEUs)

•  Case Management for the Elderly:  Facing Ethical Challenges in a Reforming Healthcare System
Outlines the issues involved in discharge planning/case management including family dynamics and education, community resources, long-term care placement, documentation, physician communication and rehospitalizations.  Ethical challenges will be explored, and the best case management practices contained in CMS’s State Operations Manual Hospital Appendix A (Interpretive Guidelines) will be discussed.

•  Chronic Disease Management: The Case Manager’s Role in Preventing Rehospitalizations
Explores the latest research, Medicare pilot projects, and care strategies regarding chronic diseases such as stroke, COPD, diabetes, CHF, etc. and provide tools to assess patients in managing their diseases at home.

•  Health Literacy:  Do Your Patients Really Understand Their Medical Treatment Plan?
Addresses one of the most pervasive and under-recognized problem in medicine:  Low levels of health literacy (the ability to obtain, understand, and use health information).  Changes in the Joint Commission regulations, the Plain Writing Act, and the National Action Plan to Improve Health Literacy will be discussed along with success stories regarding reduced rehospitalizations and patient compliance.

•  Home Health vs. Hospice:  Answering the “How, When and Why” Questions Regarding Patient Referrals
Explores the age old question:  Is my patient more appropriate for home health or hospice services?  With the use of case studies, discusses Medicare regulations regarding each level of care as well as patient eligibility and benefits.

•  Hospital, Home Health and Nursing Home Compare: What Exactly ARE These Websites Telling Me?
Provides a detailed explanation as to how the quality data is derived and presented as well as how to interpret the data to be used in effective case management and discharge planning. The major overhaul of the Medicare.gov website will be discussed in terms of additional information on survey inspections, rehospitalization rates, antipsychotic medication use in nursing homes, patient satisfaction ratings, etc.

•  The Nursing Home and Hospital Partnership: Collaborative Efforts to Prevent Avoidable Hospitalizations
Explores innovative programs that promote successful transitions of care from the acute setting to the SNF/long-term care facility.

•  Palliative and Hospice Care: Helping Patients Navigate End-of-Life Treatment Decisions
Provides information and resources regarding palliative and hospice care so that healthcare professionals can assist their elderly patients in evaluating care options.

•  Transitions of Care for the Elderly:  Providing Quality Services in the Appropriate Setting
Describes the various healthcare delivery options for the elderly as they move from one level of care to the next and introduces various transitions of care programs whose goal is to decrease unnecessary hospitalizations.