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This process provides a comprehensive assessment of each resident's functional capabilities and helps nursing home and SNF staff identify health problems. Resource Utilization Groups (RUG) are part of this process, and provide the foundation upon which a resident's individual care plan is formulated.
Utilization management is "a set of techniques used by or on behalf of purchasers of health care benefits to manage health care costs by influencing patient care decision-making through case-by-case assessments of the appropriateness of care prior to its provision," as defined by the Institute of Medicine [1] Committee on Utilization Management by Third Parties (1989; IOM is now the National ...
Case Managers concurrently plan for transitions of care, discharge and often post discharge follow up. Case Managers often coordinate with the patient and family, physician(s), funding sources (i.e. insurance, Medicare), and community resources that provide services the patient may need, such as rehabilitation facilities or providers of medical ...
Discharge planning processes can be effective in reducing a patient's length of stay in hospital. For example, for older people admitted with a medical condition, discharge planning has been shown to improve satisfaction, reduce the overall length of stay, and within 3-month period reduce the likelihood of readmission. [ 4 ]
The function of nursing care plans has changed drastically over the past several decades. In 1953, care planning was not believed to be within the nursing scope of practice. [5] In the 1970s, care planning was activity based. [5] Patients were listed according to the procedures they were having done, which determined their plan of care. [5]
There are 11 document types in the C-CDA standard [5]. Care Plan - A Care Plan (including Home Health Plan of Care (HHPoC)) is a consensus-driven dynamic plan that represents a patient's and Care Team Members' prioritized concerns, goals, and planned interventions.
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Reassessment data may be recorded in the Progress Notes, Master Treatment Plan (MTP) and/or MTP review. Progress notes are written in a variety of formats and detail ...
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