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What is Case Management in Home Care?

presented by Kim Corral and Tina Marrelli

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Disclosure Statement:

Financial: Tina Marrelli is an employee and share holder of Marrelli and Assoc. Inc, with book sales. Tina Marrelli is  a share holder with book sales of Innovative Caregiving Solutions LLC. Tina Marrelli is an author who receives book royalties from Sigma Theta Tau International Publishing. Tina Marrelli receives compensation from MedBridge for this course. Kim Corral is an employee and share holder of Chelta, Inc  Kim Corral receives compensation from MedBridge for this course. For both instructors there are no financial interests beyond the production of this course.
Non-Financial: Tina Marrelli and Kim Corral have no competing non-financial interests or relationships with regard to the content presented in this course.

Satisfactory completion requirements: All disciplines must complete learning assessments to be awarded credit, no minimum score required unless otherwise specified within the course.

MedBridge is committed to accessibility for all of our subscribers. If you are in need of a disability-related accommodation, please contact support@medbridgeed.com. We will process requests for reasonable accommodation and will provide reasonable accommodations where appropriate, in a prompt and efficient manner.

Accreditation Check:
The home health industry demands that patient care be provided in an efficient and effective manner. Case management is a strategy which supports this demand. This course defines the concept of case management and discusses the skills and core knowledge concepts required to manage not only individual patient episodes but entire caseloads of patients. Strategies for applying this process to individual patients and caseloads will be discussed with practical examples that can be applied in the care practice setting.

Meet Your Instructors

Kim Corral, RN, BSN, MA Ed, COS-C

Kim is a registered nurse with a master's degree in education and more than 30 years of home health experience. She is an experienced leader in home health care, having held both clinical and operational positions at regional and national levels for large corporate home health organizations. She brings a passion for providing the clinical…

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Tina Marrelli, MSN, MA, RN, FAAN

Tina Marrelli is the president of Marrelli and Associates, Inc., a publishing and consulting firm working in home care for more than 30 years. Tina is the author of 13 books, including the Handbook of Home Health Standards: Quality, Documentation, and Reimbursement (6th edition, 2018). Other books include A Guide for Caregiving: What’s Next? Planning…

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Chapters & Learning Objectives

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1. What is Case Management?

The term "case management" is utilized in home health to describe a method of oversight that is practiced to effectively manage patient care episodes. This method focuses on the ability to accurately assess the acuity of home care patients as well as the ability to provide and coordinate high-quality care that appropriately meets the patient's needs. The case manager is responsible for managing multiple patients holistically and across time, and this concept provides the framework.

2. Who Can Case Manage: The Role and Skill Set Required

The provision of patient care in the home can at times be a daunting task. Providing care in the home requires a specialized skill set that includes experience in clinical practice, leadership skills, strong reasoning and decision making skills, organizational skills, and more. As one can imagine, the home care practice setting is not for everyone. In this chapter, we examine the desired attributes of a case manager and the scope of this very important role.

3. Case Management of a Patient: What is Managed?

There are many aspects of care that must be managed throughout the course of a patient episode. This chapter identifies the specific areas that require close supervision, oversight, and management. A patient example is shown to better illustrate these complexities.

4. Effective Case Management: Use of the Individualized Care Plan

Provision of patient care in home care is more than providing specific tasks to a patient. The patient must be considered/assessed from a holistic perspective, meaning the home care clinician is responsible for identifying not only patient medical problems but the problems associated with the environment in which the patient lives that may impact their ability to medically improve and successfully achieve desired outcomes. The home care clinician must develop an appropriate plan to support mutually agreed upon goals for improvement in the patient environmental situations that impact care as well as support improvement of their medical status. Once this individual plan is developed, it must be managed. The individualized patient plan of care is the road map clinicians utilize to assure that the care is managed effectively across all disciplines. This chapter looks closely at the aspects of patient care that must be carefully managed.

5. Managing a Caseload of Patients

Successful caseload management is directly related to the organizational skills of the case manager. This chapter discusses organizational strategies and tips to support effective caseload management. There are different models for the organization or oversight of care management. Some of the ways to effectively manage caseloads will be presented and explored.

6. The Positive Impact of Case Management

Healthier, happier patients and community can have a lot of benefits, including improved clinical and financial outcomes. This can lead to better relationships with referral sources and physicians. This chapter discusses the ways positive case management can impact home care.

More Courses in this Series

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Presented by Kim Corral, RN, BSN, MA Ed, COS-C and Tina Marrelli, MSN, MA, RN, FAAN

Welcome to Home Care: An Overview

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This foundational course offering provides a big picture overview of home care. Home care comprises many models of care delivery systems and types of home care. A brief history of home care, a snapshot of where we are now by the numbers, and the differences between home care and any other health care practice setting are addressed. A holistic and practical definition of home care is also presented. Additionally, this course will also explain why having exemplary clinical, self-motivational, organizational, and people skills is key to success in home care practice and management.

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Subscribe now, and access clinical education and patient education—anytime, anywhere—with video instruction from recognized industry experts.
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Subscribe now, and access clinical education and patient education—anytime, anywhere—with video instruction from recognized industry experts.
The ability to perform an accurate comprehensive assessment and develop an individualized plan of care for home care patients is the foundation for care delivery in home care. This course will review the steps of the care planning process, a type of problem solving method. A discussion will be provided regarding the application of this process and the value it brings to patient care.

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Orientation Program: Team Member Safety in the Community

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Orientation Program: Team Member Safety in the Community

Subscribe now, and access clinical education and patient education—anytime, anywhere—with video instruction from recognized industry experts.
This course addresses the common safety-related factors in the community and home environments. Home care team members can be exposed to a number of potentially serious hazards which range from dangerous pets (eg. biting) to firearms (ie. guns) in homes. Environmental hazards include smoke, needlesticks, unhygienic homes, germs and pathogens, structural house problems, hoarding and many others. This course seeks to identify some of these safety hazards and dangers so that clinicians and managers/leaders can better understand and apply their risk management and safety policies related to such situations and protect their team members.

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Medicare Coverage and Documentation Requirements: The Fundamentals

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Subscribe now, and access clinical education and patient education—anytime, anywhere—with video instruction from recognized industry experts.
The value of the clinical documentation that supports the tenets of coverage and quality cannot be overstated. Clinicians and managers/leaders need to proactively describe care and services in the terms detailed in the Medicare Benefit Policy Manual, Chapter 7. This, then, is the guidebook when seeking answers, examples, and clarity. This overview describes the fundamentals of Medicare coverage and the associated required documentation to support medical necessity, the individual patient's need for the skilled care and service, and the tenets of the home care program.

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How to Make an Effective Home Visit

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This foundational course addresses the three parts of the patient home visit and information and processes that surround and support effective and holistic home visits. This includes a practical and holistic definition of a home visit, the use of the care planning process through the visit, the patient-related and other activities that occur during a skilled visit, and strategies to document care that was provided during the visit. This course will also explain why having exemplary organizational, clinical, and interpersonal skills is key to making value-based home visits. This is because numerous and complex facets of care, including the patient's goals, the plan of care, physician orders, care team members, the patient's environment, care coordination, and communication, all come together in this structured, person-centered encounter.

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