Hospital Case Management Administration

Conference Overview

In these challenging times, accountability, appropriate transitions and avoiding readmissions seem to take front and center in our health care systems management. Communication and collaboration within and across health care points of access become key strategies for optimum function. Understanding the new legislation and how these initiatives impact Hospital Based Case Management are key considerations this year.

Hospital Case Management Administration brings a cadre of experts who will address these issues and many more. Topics include Strategic Planning for the Future Role of Case Management in Uncertain Times, Getting Physician Buy In, Medicare and Legislative Updates, Readmissions and Care Transitions, and Healthcare Technology in the Current Economic Stimulus Package Time. An interactive lunch networking session discussing difficulty case scenarios will give opportunities to meet and share with your colleagues what is working for you.

Highlights of this Conference include:

• Expertise of a nationally known faculty.
• A full day Pre-Conference, “The Administrator’s Role in the Intense Audit Environment.”
• Updates on legislative changes that influence hospital case management administration best practice.
• Interactive networking sessions during lunch.
• Exhibits including new software tools and companies who can help support best practice.

Join us in Chicago during the fall season and meet others who can help address the challenges facing administrators and directors of hospital based case management.

Planning Committee

Toni G. Cesta, PhD, RN, FAAN
Senior Vice President
Operational Efficiency and Capacity Management
Lutheran Medical Center, Brooklyn, New York

Beverly Cunningham, MS, RN
Vice President, Clinical Performance Improvement
Medical City Dallas Hospital

Julie Malone, MA, RN
Program Manager • Contemporary Forums

Conference Objectives

Upon completion, participants will be able to:

• Identify transitional issues related to new regulations and legislation impacting hospital case management administration.
• Describe technology and techniques that facilitate rapid and clear internal and external communication.
• Examine strategies for successful communication with payers, non acute care providers, and upper level administration.
• Discuss new reimbursement challenges and joint commission mandates for accountability that impact hospital case management.

Who Should Attend?

• Case Management Administrators
• Utilization Management Directors
• Medical Directors
• Directors of Nursing
• Directors of Discharge Planning
• Directors and Supervisors of Hospital Case Management
• Consultants
• Educators

Conference Program

Sunday, October 11 | Monday, October 12 | Tuesday, October 13

Pre-Conference A

The Administrator’s Role in the Intense Audit Environment: Inpatient vs. Outpatient
Deborah K. Hale, CCS
This all-day workshop will focus on CMS’s newest approaches to identifying and recovering “improper” payments through their auditing processes. This intense but practical program will help you in describing and understanding Medicare’s guidelines regarding levels of care, including medical necessity of admission, out-patient observation status and much more. The ways in which your department responds to and participates in an audit can make a difference in its outcomes. Tips and tools for managing the audit process will be included.

Sunday, October 11

7:00 a.m.	Pre-Conference Registration • Check-in
8:00	RAC, MAC, RVC, ZPIC, CERT, MIC and MFCU?
	Who are they? What do they want? When should Case Management Administration get involved?
8:30	Interpreting Level of Care Regulations
	Observation Status Inpatient Status Inpatient Only Procedures The Impact of Regulations on the Case Management Administrator
10:00	Refreshment Break
10:15	Interpreting Level of Care Regulations (continued)
	Inpatient following Outpatient Surgery Outpatient Status
10:45	Reaction Strategies The Denial Danger Zone “What Not to Do and Why”
	The Case Management Administrator’s role in establishing Compliance Driven Policies and Procedures “Just put them all in Observation Status first” “Admit them all as inpatients. We can always use Condition Code 44” “The docs don’t care. Let the case managers figure it out” “We just love our new Physician Advisor. He approves almost everything” “Inpatient Only List?, No problem. They are admitted right after surgery” “Discharge planning notes always include the post hospital level of care.”
11:45	Lunch Break
1:00 p.m.	Proactive Strategies to Prevent Reactive Anxiety Getting It Right from the Start!
	Setting the tone for the department’s UM role Utilization Review Committee Physician Advisor Role Utilization Management Process Redesign Case Management – Utilization Review Role
2:30	Refreshment Break • Exhibits
3:00	Proactive Strategies (continued)
	Case Management Protocol Clinical Decision Unit Policies and Procedures for appropriate use of Condition Code 44 Pitfalls of the Provider Liable Claim Assuring the Department’s Response Strategies are Consistent and Appropriate Developing an Effective Appeals Process for Level of Care Denials
4:40	Adjourn

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Main Conference

Monday, October 12

7:00 a.m.	Main Conference Registration Check In • Exhibits
8:00	Strategic Planning/Positioning for Future Role of Case Management in Uncertain Times Kathy Rickard, MBA, BSN, RN This session envisions the future state of healthcare and explores potential new directions for the role of case management across the continuum. Examines current trends fiscal constraints, and the future role of case management in an increasingly data driven and highly regulated environment. Identifies crucial partnerships and linkages as well as the importance of managing all portals of entry and the information case management needs to navigate patients through the continuum while maintaining organizational survival.
8:45	Discharge Planning and the ABCs of Hospital Operations: Audits, Billing and Compliance Jackie J. Birmingham, MS, BSN, RN, CMAC What happens in hospitals doesn’t stay in hospitals!!!! Discharge planning is a ‘clinical service’ with a significant impact on finances and compliance for hospitals and into the ‘continuum’ of care. This session will provide specifics on what administrators need to know about audits of care processes, including quality, billing details, and how compliance influences practice.
9:45	Refreshment Break • Exhibits
10:15	The Best Defense is an Offense: Building and Optimizing A Compliance Program that Leverages Case Management Expertise and Medical Advisement. Joseph Zebrowitz, MD Provides insight into building and optimizing your UR committee and process; sorts out MACs, RACs, CERT, MPMP, the 9ts SOW and MMA. Provides ten survival techniques to address the growing challenges hospitals face in protecting themselves from False Claims Act Actions based on the lack of medical necessity.
11:00	Reimbursement Update for 2010: MS-DRGs and Other Key Reimbursement Issues that Impact Case Management Deborah C. Hale, CCS Each year CMS makes significant changes to both the Inpatient Prospective Payment System and the Outpatient Prospective Payment System. This session will highlight changes for 2010 that every case management administrator needs to know.
12:00 p.m.	Questions and Discussion Faculty Panel
12:30	NETWORKING LUNCH Difficult to Discharge Scenarios (Using SBAR as a Communication Tool) Facilitated by: Jackie J. Birmingham, MS, BSN, RN, CMAC The SBAR (Situation, Background, Assessment and Recommendation) method of communication will be used by participants to structure an approach for common situations. The best resource for dealing with difficult ‘discharge situations’ are colleagues who have dealt with the same or similar situation. Come prepared for lunch and open discussion.
2:00	Putting the Right Persons in the Right Positions: Case Management Models Toni G. Cesta, PhD, RN, FAAN How many case managers does a department need? How many social workers? How can I optimize the staff I currently have? This session will focus on the determination of appropriate staffing ratios and how they are applied to best practice case management models.
2:45	Making the Case to Upper Management: How to Communicate Up Kathy Rickard, MBA, BSN, RN Explores the key information collected by case management that upper management needs; examines methods to present this information to senior leadership as well as addressing how to tailor messages to fit the target audience.
3:30	Refreshment Break • Exhibits
4:00	Getting Physician Buy in and Support: How Hospitals and Physicians are Aligned in Compliance Joseph Zebrowitz, MD Hospitals and physicians are at risk if they do not work together as Claim Concordance is implemented. Highlights points of intersection between hospital and physician administrative processes; how CMS monitors compliance; key processes to put in place to ensure concordance and how to develop an action plan.
4:45	Questions and Discussion Faculty Panel
5:20	Adjourn

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Tuesday October 13

7:00 a.m.	Exhibits
8:00	Developing an Access Point Case Management Program Toni G. Cesta, PhD, RN, FAAN This practical session will focus on the staffing and infrastructure needed to develop a state of the art access point case management program including one in the admitting department as well as in the emergency department. Also included will be roles, functions and outcome measures for determining success.
8:45	Revenue Cycle Management: What’s Case Management Got to Do with It? Beverly Cunningham, MS, RN What are the top ten revenue cycle concerns for a hospital and how can a case management administrator impact them? This session reviews the process for the revenue cycle and recommends best practices for a Case Management department.
9:30	Refreshment Break • Exhibits
10:00	Ten Wrap-around Practices to Prevent Readmissions Karen Zander, MS, RN, CMAC, FAAN Following review of research and practice regarding readmissions, ten practices are distilled. Implications of CMS’s ninth statement of work(SOW) will be addressed, placing case management in the center of success.
11:00	Developing an Orientation Program for New Case Managers: What’s New in the Zoo!! Beverly Cunningham, MS, RN With the challenge in turnover rate for case management departments, orientation is key. The leader’s role in assuring essential tasks and roles are covered during this critical time for the novice case manager. This session will describe the critical steps for an orientation program.
11:45	Questions and Discussion Faculty Panel
12:15 p.m.	Lunch Break
1:15	Using Avoidable Delay Data to Facilitate Change Toni G. Cesta, PhD, RN, FAAN Whether you call them avoidable days, avoidable delays or variances, this data can be very helpful to any organization in determining common bottlenecks and barriers to effective outcomes are located. This session will discuss the data sets to be collected, how to collect them and how to use the data to support change.
2:00	Healthcare Technology and the Impact of the Stimulus Package Jeanine M. Tome, MSN, RNC, ACM, CPHQ This session will explore the commitment of 19.5 billion dollars in the Stimulus Package to support adoption of electronic medical records by hospitals and physicians. The elements of the Health Information Technology for Economic and Clinical Health Act’’ ( HITECH), the proposed impact on patient care in meeting the requirements for“meaningful E.H.R. use”, and the implications for care management practice across the continuum of care will be examined.
2:45	Refreshment Break
3:15	Developing a Successful Patient Transition Program: Tools, Implementation, Data for Measures of Success Sandy McFolling, MS, RN, ACM Examines barriers to effective hand off communication and transitions in care. Describes tools and strategies to identify and resolve problems as well as create long term solutions.
4:00	Questions and Discussion Faculty Panel
4:30	Conference Summary and Evaluation
4:45	Adjourn

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Conference Faculty

Jackie J. Birmingham, MS, BSN, RN, CMAC Vice President Curaspan Health Group, Inc. Newton, Massachusetts	Kathy Rickard, MBA, BSN, RN Associate Director Clinical Resource Management & Social Work Hospital of the University of Pennsylvania Philadelphia, Pennsylvania
Toni G. Cesta, PhD, RN, FAAN Planning Committee Member Senior Vice President, Operational Efficiency and Capacity Management Lutheran Medical Center Brooklyn, New York	Jeanine M. Tome, MSN, RNC, ACM, CPHQ Chief Clinical Officer Allscripts Care Management Chicago, Illinois
Beverly Cunningham, MS, RN Planning Committee Member Vice President Clinical Performance Improvement Medical City Dallas Hospital Dallas, Texas	Karen Zander, MS, RN, CMAC, FAAN Principal & Co-Owner The Center for Case Management, Inc. South Natick, Massachusetts
Deborah K. Hale, CCS President Administrative Consultant Service, LLC Shawnee, Oklahoma	Joseph Zebrowitz, MD Executive Vice President Senior Medical Director Health Executive Resources Philadelphia, Pennsylvania
Sandy McFolling, MS, RN, ACM Director of Case Management Rush University Medical Center Chicago, Illinois

Accreditation

A Certificate of Attendance is given upon completion of course requirements, enabling you to register your credit with the appropriate licensing boards or associations. To apply for credit not listed below, use the procedure established by the specific organization. Additional brochures and evaluation forms provided upon request.

Nurses and Nurse Practitioners

Contemporary Forums is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

Contemporary Forums is approved by the California Board of Registered Nursing, Provider #04516.

(CA BRN contact hour = 50 minutes)

Chicago (Hospital Case Mgmt. Adm.)
Pre-Conference A
6.5 ANCC contact hours 8.0 CA BRN contact hours

Pre-Conference B N/A

Main Conference
14.5 ANCC Contact hours 17.5 CA BRN contact hours

Social Workers/Marriage, Family & Child Counselors

This Conference has been approved by the Washington Chapter, National Association of Social Workers (NASW) for Licensed Social Workers, Licensed Marriage & Family Therapists and Licensed Mental Health Counselors, Provider #1975-148.
This course meets the qualifications for continuing education credit hours for Marriage, Family & Child Counselors and/or Licensed Clinical Social Workers as required by the California Board of Behavioral Sciences, Provider #PCE771.

Chicago (Hospital Case Mgmt. Adm.)
Pre-Conference A 6.5 hours

Pre-Conference B N/A

Main Conference 14.5 hours

Case Managers, Certified Disability Management Specialists, and Certified Rehabilitation Counselors

Application has been made for the listed hours from the Commission for Case Manager Certification, Commission for Disability Management Specialist Certification, and Commission for the Certification of Rehabilitation Counselors.

Chicago (Hospital Case Mgmt. Adm.)

Pre-Conference A 6.5 clock hours

Pre-Conference B N/A

Main Conference 14.5 clock hours

Other Professionals

You will receive a Certificate of Attendance verifying your attendance at this course. Please comply with the guidelines of the appropriate boards, organizations or agencies in registering your credit.

Chicago (Hospital Case Mgmt. Adm.)

Pre-Conference A 6.5 hours

Pre-Conference B N/A

Main Conference 14.5 hours

Exhibits

To enhance your educational experience, we are inviting representatives from professionally relevant companies, organizations and hospitals to exhibit equipment, supplies, services and career opportunities. The schedule provides participants time for one-on-one discussion with exhibitors. For exhibit space availability or additional information:

Call the Exhibitor Information Line: (925) 828-7100, Ext. 5260

For prospectus information

Email: exhibits@cforums.com

Location

Chicago

Chicago is truly a cosmopolitan city, known for its architectural beauty, sophistication and exciting activities. Its sleek skyscrapers form a breathtaking backdrop for the miles of beautiful beaches, parks and gardens that border Lake Michigan. Chicago’s location has made it a convenient hub of activities for many years and the ideal setting for “Hospital Case Management Administration.”

Chicago offers unlimited opportunities for fun, culture, shopping and dining. Expand your horizons with a visit to the Museum of Science and Industry, the Field Museum of Natural History, the Shedd Aquarium or the Adler Planetarium. View some of the world’s finest art treasures at the Art Institute and Museum of Contemporary Art. Shopping always provides a great diversion, and Michigan Avenue’s Magnificent Mile and the impressive eight-story Water Tower Place have everything you could want from quaint boutiques to famous name stores. And while you’re in the area, enjoy the breathtaking view of the entire Chicago scene from the Sears Tower, one of the world’s tallest buildings.

End your busy day with a superb dinner at one of Chicago’s many casual and fine restaurants, attend a concert or play, or pick from a wide variety of entertaining jazz clubs, coffee houses or nightclubs. Chicago spells excitement, 24 hours a day!

The Conference headquarters, the elegant Hyatt Regency Chicago, exemplifies the excitement and fascination this city holds. This modern 36-story twin-tower hotel is located in the heart of Chicago’s Magnificent Mile, within walking distance of many of the city’s best restaurants and entertainment attractions as well as fabulous shopping. In addition, you can relax after the meeting sessions with your friends and colleagues in the hotel’s own assortment of fine restaurants and lounges.

You are certain to find your stay filled with exciting places to go and things to do, making it the ideal location for this national Conference. To receive more information about the Conference city, call the Chicago Convention & Visitors Bureau at (312) 567-8500 or visit their website at www.chicago.il.org.

Hotel/Travel

Hotel Accommodations

Special group rates are in effect for participants and their guests, based on room availability.

You must make your reservation early and before the “hotel room block release date” listed for each hotel. Rooms may sell out before this date so be sure to make your reservation now. After the release date, rooms and group rates may no longer be available so call the hotel for availability.

For room reservations, call the hotel and inform them that you are attending the Contemporary Forums’ Conference Hospital Case Management Administration. Request a confirmation number and written confirmation of your reservation.

Contact the hotel regarding cancellation policy. For arrivals after 3 p.m., please call the hotel on the day of travel to reconfirm reservations.

For assistance in locating a roommate, call Contemporary Forums at (800) 377-7707, Ext. 0.

This Conference will be held at the Hyatt Regency Chicago located at 151 E. Wacker Dr., Chicago, IL 60601.

Hotel room block release date: September 16

Rates: $259 single/double
Rates are per room and subject to prevailing state and local taxes.

Reservations must include a first night’s deposit.

For room reservations call (800) 233-1234, 24 hours daily. For additional hotel information, call the Hyatt Regency Chicago at (312) 565-1234.

Travel Discounts

Contemporary Forums has a special discount agreement with United Airlines unavailable to the general public. To obtain these special Conference fares either go online at www.united.com or call the Special Meeting Desk at (800) 521-4041, Account Code 510CW. Ticketing and payment can be done directly by you or through your travel agent. To ensure the best flights and times, since seats are limited, make your reservations early. Fares are guaranteed at the time of ticket purchase.

Relax and stretch out before and after you hit the convention floor—you can now enjoy JetBlue’s award-winning service and roomy leather seats for less! Book now and choose your way to save:

Traveling by yourself — Use convention code: Hospital Case as you book on jetblue.com/promo to save 5% off your travel.

Traveling as a group of five or more - Use JetBlue’s Meetings & Convention program to receive a customized fare. Simply call our dedicated desk at 888-JETBLUE, prompt 4. Your group will also receive one free change waiver per traveler.

Hertz is the official car rental agency for the Conference. Special rates will be in effect throughout the Conference as well as one week before and after. To obtain the special rates, call HERTZ at (800) 654-2240 and refer to Contemporary Forums plus the Conference discount code CV# 03000213.

Fees

Registrations must include full tuition payment to be accepted. Registrations faxed without payment will not be processed. Confirmation is sent if your completed registration form and payment are received two weeks before the appropriate Conference begins. Since Conference registration and hotel rooms are limited, early registration is advised.

Out of consideration to registrants, children of any age and spouses may not attend the sessions.

Tuition Fee (U.S. Funds)
	Pre-Conference	Main Conference (Includes One Lunch)
Early Fee*	$285	$725
Regular Fee	$335	$795

*Payments postmarked or telephone/fax registration made with credit card on/before August 31, 2009. Your tuition includes Certificate of Attendance, Conference Guide, refreshment breaks and one lunch.

Group Discounts (Mail, fax or call in together – no online registration available)

Tuition discounts are given to groups of 3 or more registering for the complete Main Conference. Discounts do not apply to the Pre-Conference(s). To qualify for the group discount, all registration information must be complete for all group members, payment included and forms sent together. If faxing, list all group members on cover sheet. Subtract the discount from the tuition fee. Groups may not be formed after individual registrations are received.

• $25 per person discount for 3 or 4 in a group
  $45 per person discount for 5 or more in a group

Method of Payment for Tuition

Make payment by check (payable to Contemporary Forums and enclose with Registration Form), Visa, MasterCard, Discover Card, American Express or Purchase Order. A $30 fee is charged for any returned check. Personal checks are NOT accepted at the Conference. Purchase Orders must be received with registration by the Conference date and include the P.O. number, invoice address, tuition, approval signature, and contact name, email address and phone number.

Register by Phone, Fax, Mail or Online(Payment is required to register)

Register only ONCE, by mail, or click here, fax (800) 329-9923 or call (800) 377-7707, Ext. 5252, Monday-Friday, 8 a.m. - 5 p.m. (Pacific Time). Before calling, complete all registration information.

Tax Deductibility

Expenses of training, including tuition, travel, lodging and meals, to maintain or improve skills in your profession may be TAX DEDUCTIBLE. Consult your tax advisor.

Partial Attendance (No online registration available)

Call Contemporary Forums for tuition and CE credit for individual days. Group discounts do not apply. Registrations may not be shared.

Cancellations

Cancellations may be made by phone or in writing. Cancellations received on/before the appropriate early registration fee deadline receive a full tuition refund. Cancellations received after that date are assessed a $20 processing fee. No refunds for cancellations received after the Conference begins or for “no shows.” If this meeting is cancelled for any reason, including labor strikes or acts of God, liability is limited to a full refund of registration fees.

Program Changes

Contemporary Forums reserves the right to make necessary changes in speakers, topics or schedule. The most current program can be found on our website.

Questions? Contact Contemporary Forums at (800) 377-7707, Ext. 0, Monday - Friday, 8 a.m. - 5 p.m. (Pacific Time) or info@cforums.com.

If you require special arrangements at this Conference, call (800) 377-7707,Ext. 5252, at least 30 days prior to the Conference.