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Theresa is a 90-year-old patient who was taken to hospital due to certain complications with breathing. She was diagnosed with cardiopulmonary disease, and her health was deteriorating. Theresa has not been responding to treatment. She was advised of possibly passing in the next 3 months. The doctor recommended pain medications and suggested skilled nursing services and personal care for. Unfortunately, the nearest skilled nursing facility has not been doing well and is about to close down. Theresa’s grandchildren have been taking turns caring for her at home. The grandchildren cannot provide the 24-hour care that she needs.
Unless home support is put in place for Theresa, she has to continue hospitalization unless she is guaranteed 24-hour care at home. The grandchildren decided to hire home care for their grandmother, and Theresa was discharged home. Case management permitted discharge and maintenance at home. Unfortunately, Theresa passed away within 20 days of discharge. The business department had prepared the bill for services rendered to her. The bill included the following:
Fee for hospital stay per day was $ 700
Home health expenses were $ 2,000 within network and $1,500 for outside of network providers
Case management fees were $ 750 (due to an effective case management strategy, the family was able to save some money).
Using the case study above, complete the following:
Prepare a confidential case report for Theresa showing net cost savings as a result of effective case management.
Prepare a case identification process for Theresa regarding her visit to the hospital.
What would you do as a potential health care administrator to improve the quality of care of a skilled nursing facility that you have been hired to head?
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