Handbook of Subacute Health CareJones & Bartlett Learning, 1995 - 355 páginas Guide to Clinical Resource Management is the first in a series of three handbooks. Clinical Resource Management (CRM) is the next stage in the evolution of restructuring/reengineering. It involves advanced practice clinical case management, restructuring the quality and utilization departments, and creating multidisciplinary clinical service teams that cross the traditional boundaries of hospital departments, clinics, and physicians. The handbook details the design, implementation, and evaluation of a CRM program in an institution well advanced in restructuring the delivery of acute care and offers a strategy for surviving and succeeding in a managed care environment. |
Contenido
Chapter 1The Subacute Care Industry | 3 |
Chapter 2Federal and State Policy Initiatives and the Subacute Industry | 15 |
Chapter 3Subacute Provider Profile | 31 |
xi | 37 |
Medicare Medicaid | 39 |
Freestanding SNFs | 46 |
Managed Care Reimbursement Mechanisms | 54 |
Chapter 5Physical Facilities for Subacute Programs | 61 |
Conclusion | 160 |
28 | 161 |
Chapter 11Business Office Operations for Subacute Providers | 167 |
BookkeepingBilling | 174 |
Appendix 11A | 180 |
Chapter 12Management Information Systems for Subacute Care | 189 |
Clinical Management | 195 |
Case Management | 201 |
Construction Issues | 67 |
HospitalBased Subacute Care Program | 74 |
Appendix 5A | 81 |
888 | 88 |
Conclusion | 91 |
15 | 96 |
Appendix | 99 |
Consulting Staff | 107 |
18 | 111 |
Staffing Ratios for Specific Subacute Programs | 113 |
Chapter 8Case Management for Subacute Programs | 117 |
Qualifications of a Good Case Manager | 124 |
The Referral Development Process | 130 |
Referral Source Maintenance Program | 137 |
Chapter 10Subacute Outcome Measurement and Critical Paths Development | 143 |
Data Uses | 150 |
An Overview | 213 |
Appendix 13B | 219 |
External Assessment | 225 |
Conclusion | 233 |
Joint Venture Arrangements | 243 |
Conclusion | 251 |
Chapter 16Financial Feasibility for Subacute Providers | 259 |
Ancillary Cost and Charges | 265 |
Chapter 17Preopening and StartUp Operations for Subacute Providers | 271 |
Chapter 18Preopening Marketing Program for Subacute Providers | 277 |
Chapter 19Managed Care Contracting for Subacute Providers | 283 |
PART IVHEALTH CARE REFORM AND THE SUBACUTE INDUSTRY | 295 |
Conclusion | 306 |
| 343 | |
Términos y frases comunes
Accreditation acute hospital admission appropriate areas assessment benefits billing certified clinical clude contract coordinator coverage criteria critical path delivery designed diem employer ensure environment evaluation federal freestanding function goals grams HCFA health care reform HMOs hospital-based SNFs identified implement inpatient issues length of stay licensed licensure long-term care managed care organizations Medicaid Medicare Medicare patients ment monitor needs nursing assessments nursing care plan occupational therapy outcome measures patient day payment physical therapy physician policies procedures program director rates referral development referral sources regulatory Rehabilitation Hospital requirements respiratory respiratory therapy skilled nursing facility specialty hospitals specific Staff Staff Staff staffing standards strategy subacute care subacute facilities subacute patients subacute program subacute providers subacute services subacute setting subacute unit swing bed program tal-based target TennCare therapists tients tion treatment types utilization review viders