Case Management

CFMC’s case management program ensures that patients receive appropriate, high-quality services in a timely, cost effective manner. Our collaborative process follows the guidelines of the Case Management Society of America:

Assessment
Planning
Implementation
Coordination
Monitoring
Evaluation

These key components ensure a logical and effective way to assist case managers in meeting the goals established by the entire health care team. We use case management to better meet patients’ needs and improve their treatment outcomes by coordinating the full continuum of care.

We assign patients to case management based on their primary diagnosis and their need for support and coordination of services. The majority of case management patients have primary medical conditions. However, our experience indicates that recipients usually have both medical and behavioral health needs, and we take care to address both.

Our nurse case managers:

identify and engage patients in appropriate care;
develop coordinated, collaborative plans with all involved providers;
monitor appropriateness of care;
facilitate timely discharges and transfers based on individual needs and care requirements;
educate patients to help them understand their health choices and assist them in making informed decisions about their health care;
serve as a resource to patients, health care professionals, facilities, health plan representatives, care givers and family members; and
monitor cost-effective use of resources.

Currently, we offer an extensive array of case management programs:

Rehabilitation
Behavioral health
Medical/Surgical
Catastrophic
Transplant services

Questions?

Contact Nancy Borgstadt, RN, MS, CNS, director of review services at 800.950.8250 ext. 3153, or e-mail Nancy at nborgstadt@cfmc.org.