Table of Contents

• Preface, Disclaimers, Other important information
• Introduction to case or care management
• Geriatric Case Managers
• Patient Selection for CM
• Case Management Program
• CM - What is it?
• CM skills
• CM Information Systems
• Mentoring
• CM - policy and procedures
• Social Work Case Management Competency Requirements
• Certification requirements for social work case manager
• Case Management Accreditation
• Hospital UM/Care or Case Management Staff Functions
• Roles and responsibilities of hospital-care focused UM staff
• Roles and responsibilities of ambulatory-care focused UM staff
• Primary case manager
• Specialty CM/Clinical Nurse Specialist - roles and responsibilities
• Criteria for specialty case management referrals and case acceptance
• Specialty case management - policy and procedures
• Telephone case management
• Criteria for Social Service/Counseling Management -
• Specialty case manager - Case closing
• Intake Form - example content
• Specialty case manager - Discharge form
• Hospital case manager - UM variance reports
• CM: Skilled Nursing Facility
• Skilled vs Custodial (non-skilled) Levels of Care Services
• Custodial Level of Care – Questions and Answers
• What are the concerns about SNF admissions?
• CM: Home health and hospice services
• Patient Choice re: HHA Ownership Disclosure Form – Example
• CM: Discharge planning P&P
• Hospitalist program post-discharge transitional management of care
• CM: Homebound program
• Homebound program assessment survey
• High risk screens for new health plan members
• CM: New patient preliminary screening triggers and actions
• CM: Outcome Measures
• CM: Addiction Management
• Case Management in the ED for High Utilizers
• High risk case detection for focused case management
• CM Screen example for high risk patients
• Case management for disease specific referral programs
• Cases (example list) to screen or target for CM services
• Congestive heart failure CM
• Diabetic Case Management
• Heparin-coumadin conversion program
• HIV – Case Management
• Hip Fracture – Case Management
• Obstetrical case management
• End-of-life care - case management
• Mental Health Case Management Services - protocols, policy

CM triggers for the patient requiring behavioral health care

CM: Behavioral Healthcare – Policy example

Clinical case management

Community-based services

Depression Care - Case Management

Children/Adolescent Case Management Services - Oklahoma Foundation for Medical Quality (OFMQ) Case Management Program

Client Assessment Record (CAR)

• Case Loads – 2001 survey data
• Position descriptions
• Hospital Director, Case Management Services
• Case Manager, Primary Care/Ambulatory Care
• Case Manager, Hospital
• Case Manager, Specialty Care
• HIV/AIDs Nurse Case Manager
• Case Management Coordinator
• Social Worker, MSW
• Social Worker Case Manager Competency Requirement List
• Social Work Director
• Discharge Planner: Position description
• CM Candidate Screening Tool
• CM: Duties
• CM Credentialing Resources
• CM Plan - example
• Care coordination program - example
• CM-related organizations
• CM references and resources
• Case-mix adjustment; severity of illness resource
• Web Sites – Case Management, Nursing
• CM Notes