Case Management

Home > Case Management

Case Management Nurses coordinate long-term care for their patients. Their goal is to treat their patients at optimal times to keep them healthy and out of the hospital.

Case management nurses are specialized registered nurses who manage the long-term care plans for patients with chronic or complicated medical conditions. These nurses work closely with patients and their loved ones to evaluate patients’ needs and come up with a comprehensive healthcare plan that speaks to their preferences and goals.

Beyond managing patients’ healthcare plans, a case management nurse also has the opportunity to work in a social work capacity, for example by helping patients and families to resolve financial issues. These nurses act as advocates to ensure that each patient receives the most cost-effective care possible. Advocacy includes medication management and scheduling medical testing and any necessary follow-up to ensure that each patient is heard and afforded the care he needs.

Acting as patient care liaisons, case management nurses coordinate the care that patients receive from each healthcare provider and manage plans for chemotherapy, radiation therapy or other continued therapies. They arrange for transfers among units within a hospital, or from a hospital to another care facility such as a nursing facility, rehabilitation center, long-term care facility, or homecare. The critical help they provide provides peace of mind and a sense of security to patients and their families.

Case managers ensure that ethical and legal issues are addressed. They also ensure that patients receive medically appropriate services. They need to be experts regarding public and private insurance reimbursement policies regarding healthcare.  Case managers review charts and meet with other health care professionals to ensure that patients receive appropriate levels of care. They facilitate admission and discharge processes.

Case managers work holistically, ensuring that care and discharge plans meet the physical, social, and emotional needs of patients.

Why Hire a Private Case Manager?

“During one especially dicey period with my mother, then in an assisted living facility, my brother and I hired a private case manager, first for a consultation and then for additional help at an hourly rate. It felt like such an extravagance, given that we weren’t rolling in money, but the care manager helped solve a series of complex problems that I doubt I’d have solved by myself, mostly involving brokering a compromise with the facility, whose management wouldn’t let me hire a private aide for my mom but could not provide what she needed.

Relations had soured to the point that all I could do was scream at them, which was making a bad situation worse, so having an advocate was a blessing. Also, the care manager, who visited regularly with my mother, often was privy to concerns she was keeping from me, and she was always there for me by telephone, which was a lifesaver.”