Observation Services: How Case Managers Can Lead the Way

Creating an Action Plan for Proper Documentation, Billing and Compliance

About the Webinar Program Objectives Webinar Will Answer These Questions Speakers Who Should Attend Purchase Options Continuing Education Questions

Attend from your desktop or conference room. Invite your whole team to attend at one low price of $329 per location. Each registration comes with access to the archived version of the program and the materials until December 31, 2011. Continuing Education: This program is approved for 1.5 contact hour for nurses, social workers, certified case managers, disability management specialists, psychologists, and licensed mental health counselors.

The role of the acute care case manager is expanding, and one place where frontline case managers can make a deep impact is the area of patient status – and the confusing subject of observation services.

When it comes to observation, reimbursement, compliance and patient satisfaction are three of the biggest issues at stake – and all three are linked to the financial viability of acute care facilities. While the observation services designation is driven by a physician, the surrounding case management staff has the opportunity to ensure that documentation is correct, that services are appropriate and that the patient is aware of their situation and satisfied with their care.

Join the Case In Point Webinar series as a faculty of case management leaders identify the leading strategies, teams, processes and programs created to ensure compliance and drive optimal reimbursement from payers, all while maintaining tools and tips for patient satisfaction.

Key Strategies You Will Learn:

• How case managers can take the lead and drive quality.
• Steps to secure physician education.
• Techniques to optimize ED workflow plans.
• Tips for documentation, billing and compliance.
   

About the Webinar

With inpatient admissions criteria more stringent than ever, hospitals must fully understand the opportunities available when applying designations to patients. Implementing best practices in documentation, billing, medical necessity and pre-access plans will make sure hospitals are securing reimbursement — and covering their history in a safe way to ward against federal auditing bodies.

For what seems like a simple designation, observation status is proving to be a complicated and potentially costly aspect of Medicare admissions. Recently, one hospital on the west coast was forced to recompense the federal government to the tune of $2.2 million because of an observation vs. inpatient discrepancy.

“Observation status is an administrative classification of patients seen in hospital emergency rooms or outpatient clinics who have unstable or uncertain conditions potentially serious enough to warrant close observation, but usually not so serious to warrant admission to the hospital,” describes the Agency for Healthcare Research and Quality (AHRQ).

Yet despite these defining terms, observation status is far from clear cut. “The designation of ‘observation status’ patients by hospitals is not well understood and has the potential to distort traditional measures of inpatient hospital utilization,” concludes AHRQ.

This Case In Point webinar is aimed at giving healthcare practitioners, particularly case management teams, in facilities the knowledge and know-how they need to adhere to appropriate guidelines, secure proper documentation and “observation history,” and install proven programs that have show to avoid costly audits and maximize reimbursement. 

Program Objectives

• Define observation services and the surrounding issues.
• Identify the key areas where case managers can implement quality-driven programs.
• Describe the vital area of documentation, and the strategies to secure it.
• Explore best practices aimed at improving patient satisfaction.
• Identify how emergency departments can improve their observation workflow.
   

Our Webinar Will Answer These Questions

• What is the definition of observation services?
• Who is involved in observation designation in optimal situations?
• How can case managers take leadership positions on this issue?
• What tools and strategies can improve compliance?
• What tactics have proven to boost reimbursement capability?
• How can a comprehensive action plan boost the health of my facility?
• When should a case manager start to be involved in observation designation?
• What do best-practice programs involve on the team?
• What is the full potential of a thorough observation program?
• How can I improve patient satisfaction at my facility?

Faculty

Louis G. Graff IV, MD, FACEP, FACP, is Medical Director of Quality & Associate Director of Emergency Medicine at The Hospital of Central Connecticut, New Britain, Connecticut. He has written/edited four textbooks, four monographs and over 100 peer review articles, editorials, and book chapters. Dr. Graff has shown expertise and leadership in the development of Observation Services level of care to improve physician diagnostic and therapeutic performance while also improving utilization of scarce health care resources. He founded and chaired the Society for Academic Emergency Medicine (SAEM) Observation Medicine Committee 1989‑1991. 1991 during which the committee successfully published an Annotated Bibliography on Observation Medicine (Amer J Emerg Med 1992:10;84‑93), sponsored a national debate on the value of Observation Medicine, (Ann Emerg Med 1992:21:967‑975), published a curriculum on Observation Medicine (Ann Emerg Med 1992:21;963‑966). He then founded ACEP's section of membership on Observation Services in 1990 and chaired the section 1990‑1993. Deirdre Hodges, RN, CCM, is the team leader of inpatient case management/utilization management at St. Joseph Mercy Medical Center in Hot Springs, Ark. Ms. Hodges has been involved in nursing for 17 years, and holds extensive experience with pediatric and adult case management outpatient, home care and inpatient settings. Hodges received her associates degree at Dutchess Community College in Poughkeepsie, N.Y., and her bachelor’s degree at Westfield State University in Westfield, Mass.                 Marcia A. Colone, PhD, ACM, LCSW, is currently system’s director of Coordination and the Clinical Documentation Program at UCLA Health System in Los Angeles, Calif., which is comprised of two hospitals. Previously she was director of Case Management, Clinical Documentation Program and the External Transfer Program at Northwestern Memorial Hospital in Chicago, Ill., from 1992 to 2008. She received her Ph.D. in Social Welfare Administration from the University of Chicago in 1989 and two master’s degrees in Special Education (1976) and Social Work (1982). Dr. Colone is a nationally recognized leader and frequent speaker in the field of contemporary care coordination practice, emerging models of health care delivery models, leadership development, personal empowerment, and change management. She is a published author of several book chapters and articles and frequently presents these topics and others throughout the country. Mary Noli-Pilkington, RN, CCM, is the Manager of Care Coordination at Ronald Reagan UCLA Medical Center in Westwood, California. Ms. Noli Pilkington manages Case Management and Social Work for Emergency, Medicine, and Rehabilitation Services at UCLA’s Westwood facility. Ms Noli Pilkington helped launch UCLA observation unit offering expertise in case management and utilization review. Mary has broad experience in nursing beginning her career in1980 at North Shore University hospital as a bed side nurse in a Cardiac Step Down unit to her present position managing care coordination practice at UCLA. Ms Noli Pilkington has presented models of care coordination as well as contemporary care coordination strategies at national conferences. She received her ADN. from Nassau Community College in Garden City New York and is a present member of the planning committee for NICM/ACM national conference in 2012.

Moderator:  Anne Llewellyn RN-BC, MS, BHSA, CCM, CRRN  Editor in Chief, Case Management Products  Dorland Health, a Division of Access Intelligence

Who Should Attend

Purchase Options

• Live Webcast Registration – $329 (per-site fee)
• Webcast Recording on CD-ROM – $329
• Live Webcast and CD-ROM – $389

Continuing Education

Nurses: This program is approved for 1.5 contact hours for nurses by Commonwealth Educational Seminars (CES). As an APA approved provider, CES programs are accepted by the American Nurses Credentialing Center (ANCC). Every state Board of Nursing accepts ANCC approved programs except California and Iowa. However, CES is also an approved Continuing Education Provider by the California Board of Registered Nursing, (Provider Number CEP 15567) which is also accepted by the Iowa Board of Nursing

Certified Case Managers: This program is approved for 1.5 contact hours for case managers through the Commission for Case Manager Certification.

Disability Management Specialists: This program is approved for 1.5 contact hours through the Certification of Disability Management Specialists Commission.

Social Workers: This program is approved for 1.5 CE hours for Social Workers. Commonwealth Educational Seminars (CES) is approved as a provider for Social Work Continuing Education (ACE Provider #1117) by the Association of Social Work Boards (ASWB, 400 South Ridge Parkway, Ste B, Culpepper, VA 22701) www.aswb.org. ASWB Approval Period: 10/6/09-10/5/12.

Questions?

For questions regarding the Webinar or to register by phone, contact Hope Kabik at 301-354-1769.

If you are having any technical difficulties or need assistance meeting these requirements, please contact our Technical Support Center at 1-866-709-8255.

For content questions regarding this Webinar, contact Anne Llewellyn at 954-254-2950 or email allewellyn@dorlandhealth.com.

*Dorland Health does not offer any refunds for the webinar.  All sales are final.

How Does the Webinar Work?

The live audio is delivered to your location over the telephone or your computer speakers. The Power-Point presentations are presented over the Internet and are available to print out before the program. This is like a talk-radio program with visuals on the Web. You and your team will be able to have a live Q&A with all the speakers.

More details on webinar equipment and connections