Case Management Jeopardy Template

Medicare	The Case Management Process	Home Health Team Members	Patient Red Flags for Case Management
100 What is greater than 65 The age at which someone can qualify for Medicare.	100 What is screening process This part of the process promotes early intervention and helps identify key information about the patient	100 What is OT This member of home health staff helps patients recover from a disease process with the focus on performing ADL and job skills.	100 What is ten days A stay of greater than how many days flags case management.
200 What is disability and/or End Stage Renal Disease Apart from age, you can also be eligible for Medicare in these two ways.	200 What is predictive model This model is integrated into case management software to forecast behaviors and trends.	200 What are home health aides This member of the team assists with hygiene tasks like bathing, housekeeping, etc	200 What is Lovenox or Heparin A patient needing this commonly prescribed anticoagulant prophylaxis medication would be considered a red flag for case management, as it falls under the "injectables" category.
300 What is: under care of a doctor, the doctor certifies there is a part-time need, the home health provider is Medicare certified, you are homebound, and the doctor has met you face-to-face. These 5 aspects must be met in order for Medicare to cover home health services.	300 What is planning phase This phase takes place after risk stratification	300 What are social workers These members address psychosocial concerns that may impede recovery	300 What is $25,000. This financial limit is a red flag for case management when it is applied to the same illness, year-to-date.
400 What is skilled nursing This additional service is needed in order for Medicare to cover home health care assistance.	400 What is planning phase This phase includes consideration of barriers to goal completion.	400 What is skilled nursing This member of home health staff provides care fewer than 7 days each week, or daily for less than 8 hours each day for up to 21 days	400 What is polypharmacy This red flag can occur when multiple providers are involved in patient care without any one point of contact for care coordination.
500 What are services not covered by Medicare Things in this category include homemaker services, meal delivery, and full-time nursing care.	500 What is implementation phase During this phase the case manager and interdisciplinary team coordinate care to meet the patient’s needs and help them achieve their goals.	500 What is informal care giver This vitally important member of the team provides daily supportive care; they may or may not be paid.	500 What is more than two chronic conditions These red flags can qualify a patient for Chronic Care Management services, dependent upon anticipated duration/severity.

Case Management

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