Case Management Compliance: What You Need to Know

Event Information
Product Format
Prerecorded Event
Toni G. Cesta, Ph.D., RN, FAAN
60 minutes
Product Description

Know the Strategies that Help Keep Rules and Regulations Hardwired Throughout the Patient’s Stay.

Rules and regulations are driving much of case management performance.  CMS often makes a regulation, then Medicaid follows it, and finally managed care. Keeping compliant should be the goal of each nurse case manager and social work case manager.

How confident are you with all the compliance that is expected of case managers? Compliance goals of case management changed with the 2014 IPPS final rules (two midnight rules, EMTALA, CoPs et al.). 

Join expert speaker Toni G. Cesta, Ph.D., RN, FAAN in this session to learn about the strategies to assure rules and regulations are met and hardwired throughout the patient’s stay. 

Session Objectives:   

  • Understand the impact of the updated Conditions of Participation on the role of the case manager.
  • Identify key strategies for hardwiring processes that will ensure compliance.
  • Review the key compliance issues affecting the case manager’s everyday practice.

Session Highlights:   

  • Review of observation and two Mid Night rule
  • The definition of discharge planning as defined by the Centers for Medicare and Medicaid Services
  • Key elements of the Conditions of Participation affecting case management’s daily practice
  • Regulatory requirements of the Conditions of Participation that CMS may audit you on
  • Review of Condition Code 44 and Provider Liable
  • A tool for identifying your compliance gaps.
  • How to work with the interdisciplinary care team to improve your department’s compliance.
  • Discussion on the Patients Right to Appeal
  • Insights in Case Management Transitions and Discharge Planning
  • New additions to the interpretive guidelines for CFR 482.3
  • Recommended procedures to ensure that your department is compliant
  • Compliance gap analysis
  • Compliance Roles of Case Management Leaders

Who should attend?

  • Case Management Directors and Managers
  • Discharge Planning Directors and Managers
  • Social Workers and Social Service Directors
  • Utilization Management Directors and Managers
  • Case management, discharge planning, social service and utilization management supervisors and team leads

Order Below or Call 1-844-384-4744 Today

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About Our Speaker

Toni G. Cesta - Healthcare Case Management Expert

Toni G. Cesta, Ph.D., RN, FAAN is Partner and Health Care Consultant in Case Management Concepts, LLC, a consulting company which assists institutions in designing, implementing and evaluating acute care and community case management models, providing on-site education to case management staff, and strategies for assisting health care organizations in improving their case management department’s efficiency and effectiveness.

The author of nine books, and...   More Info
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