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Case Management Nurses

The Case Management Department is a multidisciplinary team made up of registered nurses and licensed social workers. The primary goal of the Case Management Department is to provide patient-focused care to all patients, ensuring that each patient receives the highest quality of care possible.

Care Coordination

 
  Lisa Nickerson, RN, CCM, reviews a patient chart with Lee Lindenau Rph, one of the hospital's pharmacists.

It is the goal at Mid Coast hospital that all inpatients will be followed by a Care Coordinator who is an RN. The care coordinators are responsible for reviewing each patient’s medical needs and ensuring that patients with certain diagnoses have specific treatments that are monitored and evaluated by The Center for Medicare Services. They also work with the patients and family members to anticipate what arrangements will be needed when the patient is medically stable and ready to leave the hospital. They assist in the facilitation of a safe discharge plan with appropriate follow-up and support, so that the patients and their families will have a successful transition. They are a constant in the patient’s care, providing ongoing support and advocacy, and helping patients and their families cope during their period of acute illness.

Social Services

The Case Management Department is also comprised of licensed social workers. They respond to the emotional needs of patients by providing support during their hospitalization, helping them to cope and adjust through the acute phase of their illness. They are available to assist with financial needs, legal issues, finding alternative living arrangements, end of life issues and crisis situations.

Utilization Review

Utilization Review Nurses are another part of the Case Management team. The UR nurses advocate for the appropriate level of care for each patient. This can involve daily contact with payers such as Anthem, Martin’s Point, Cigna, Aetna or Medicare/Maine Care. Should any services be denied by insurers, the UR nurses pro-actively initiate the appeal process.