Case Management Services

...Coordinating Your Care While You're in the Hospital and Arranging a Safe and Supportive Discharge

Case Management Department

A case manager oversees the care of every patient admitted to Grand View Hospital. However, not every patient needs or wants case management. Case managers work Monday through Friday from 7:30 am to 5:00 pm. In emergencies, you may reach a case manager by calling the hospital operator and asking to speak to the on-call case manager.

There is usually no better place to be than a hospital when you are seriously ill or injured. However, most people can't wait until their health improves so they can go home. At Grand View, our nurses, doctors, social workers and other staff work together to speed your recovery. Coordinating their efforts is the case manager, who "works behind the scenes" to make sure everything goes according to plan.

MEETING YOUR CASE MANAGER
You will usually meet your case manager shortly after admission.Your case manager will be available to you and your family throughout your stay. Case managers are nurses, social workers and other health-care professionals. If you would like to see a case manager and one has not visited, please call the case management department.

YOUR CASE MANAGER

Coordinates Care within the Hospital
As a patient in the hospital, you may receive different services, such as tests, evaluations and treatments. Your case manager coordinates your care to maximize your health and comfort.We also make sure that your physician and every other member of your health-care team is kept informed.

You must make decisions regarding your care.
Your case manager will explain your options and help you understand the health-care system.We will ask you to think about your health-care goals, doctor’s instructions and insurance coverage.

If needed, we will explain your options related to advance directives. These include living wills and power of attorney for health care. Sometimes, you or your family may need help in reaching a decision regarding your care.Your case manager can arrange for you to speak with our chaplain or members of our Ethics Committee.

Works with Your Insurance
Your case manager works with your insurance provider so you get all of the insurance coverage to which you are entitled. Types of insurance include Medicare, Medical Assistance, Veteran’s insurance and private insurance, such as Blue Cross and Aetna.Your case manager coordinates health insurance benefits and obtains approvals while you’re in the hospital and in preparation for your discharge.

Arranges Care for When You Leave the Hospital
Your doctor decides when it is safe for you to leave the hospital.Your case manager makes the best recommendation for your care within the medical orders provided by your physician and services provided by your insurance. If you are not going home, you will transfer to a rehabilitation center, skilled nursing center or assisted living facility. If you are going home, your case manager can arrange for medical equipment, nursing and other health-care services in your home.

SERVICES WE CONSIDER WHEN PLANNING YOUR DISCHARGE

Rehabilitation
Your case manager will work with your insurance company to see if your admission to a rehabilitation facility would be covered. If yes, we will help you find a facility.

Skilled Nursing and Assisted Living (Personal Care) Facilities
We will give you a list of facilities and encourage you or your family members to visit the ones that interest you. After you decide where you might like to go, your case manager will help you complete the application forms. If the facility you prefer does not have an opening, you will need to choose another one.You may not remain in the hospital until an opening arises unless you are willing to pay the daily hospital rate.

The cost of staying in assisted living facilities is not covered by Medicare or most private insurance plans. However, some long-term care insurance policies do cover the costs of assisted living or skilled nursing facilities.Your case manager can help you with your financial and insurance questions.

Home Health Care
Your insurance may cover health-care services in your home. Typically, services are provided for an hour or two – one or more days a week. These might include nursing, physical, occupational and speech therapy, home health aide service or medical social work. To receive home care coverage, Medicare and most private insurances require that you are homebound. This means that you are unable to leave your home due to your medical condition.

Hospice
Hospice provides home health services and support to individuals who have been diagnosed with a terminal disease or are living with a life-threatening illness.

Medical Equipment
Your case manager can help you obtain necessary medical equipment, such as home infusion (IV), a wheelchair, walker, hospital bed or oxygen.

Referral to Government and Community Resources
County programs, such as Area Agency on Aging and Adult Services, provide many services for which you may qualify. These include Meals on Wheels, homemaker services and financial assistance.Your case manager can inform you of these services and help make connections to receive them.

Special Consideration for Expectant Mothers, Infants and Children
Many services are specially designed to meet your special needs.Your case manager will inform you about services, such as home health, medical equipment and referrals to county and community agencies specializing in pregnancy support and children and youth programs.

Case Management Services Are Available After You Leave the Hospital
Our outpatient case manager can connect you with services available in the community even after you leave the hospital.We will give you the names and telephone numbers of people to contact, explain what you might be entitled to receive and help you complete forms. For assistance, please contact the Case Management Department at 215-453-4487.

If you have a concern about your care, please contact the Patient Representative at 215-453-4975.

For more information, please contact Case Management Services at 215-453-4487.