The CoP are the legal and regulatory requirements that hospitals and case management professionals must follow in order to be compliant in their role as discharge planners.It is important that all case management professionals, including both nurses and social workers, are familiar with the changes to the Conditions of Participation for Discharge Planning that were announced in October 2019 for Federal Fiscal Year 2020. From here we will then discuss these most recent changes from the Medicare program and how they will impact the roles of the RN case manager and the social worker. Learn how to be sure that your processes address the complexities of the new healthcare environment and that your role as a case manager or social worker is designed and staffed to meet the changes ahead! Be sure you know the old rules, the new rules and the proposed rules so that your practice will be current and legal! Join us in reviewing the current rules, the new rules and the proposed rules from CMS for Discharge Planning for 2020 the proposed rules from CMS for Discharge Planning for 2020.
In this program we will review start with reviewing the current rules for discharge planning. Are you compliant with these rules? The proposed rules that are still under consideration will be reviewed as they may have a profound effect on how case management departments organize their work. It will also affect the workloads of RN case managers and social workers. Patients in ambulatory settings such as out-patient surgery, outpatient procedures and emergency departments may need to be assessed for the purpose of creating a discharge plan. Family caregivers and physicians will be expected to be much more involved than they have in the past. This program will review the current rules and regulations from the Conditions of Participation (CoP) for Discharge Planning.
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 a frequently sought after speaker, lecturer and consultant, Dr. Cesta is considered one of the primary thought leaders in the field of case management.
Dr. Cesta writes a monthly column called “Case Management Insider” in the Hospital Case Management journal in which she shares insights and information on current issues and trends in case management.
Prior to her current work as a case management consultant, Dr. Cesta was Senior Vice President – Operational Efficiency and Capacity Management at Lutheran Medical Center in Brooklyn, New York. She was responsible for case management, social work, discharge planning, utilization management, denial management, bed management, the patient navigator program, the clinical documentation improvement program and systems process improvement. Prior to her position as Senior Vice President at Lutheran Medical Center, Dr. Cesta has held positions as Corporate Vice President for Patient Flow Optimization at the North Shore – Long Island Jewish Health System and Director of Case Management, Saint Vincents Catholic Medical Centers of New York, in New York City and also designed and implemented a Master’s of Nursing in Case Management Program and Post-Master’s Certificate Program in Case Management at Pace University in Pleasantville, New York. Dr. Cesta completed seven years as a Commissioner for the Commission for Case Manager Certification.
Dr. Cesta has presented topics on case management at national and international conferences and workshops. Her books include “Nursing Case Management: From Essentials to Advanced Practice Applications”, “The Case Manager’s Survival Guide: Winning Strategies in the New Healthcare Environment”, “The Case Manager’s Survival Guide: Winning Strategies for Clinical Practice”, “Survival Strategies for Nurses in Managed Care” and “Core Skills for Hospital Case Managers”.