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Catastrophic Case Management

A Higher Calling

Meet Stephanie, CCM, RN



Catastrophic case managers must be equipped to handle the most complex injuries no matter the situation. As Genex case manager Stephanie learned, this includes managing care for an unlikely victim of gun violence in the most unlikely setting for a shooting to occur.

The case

A 76-year-old bishop was performing a religious ceremony at his church when a gunman approached and shot him several times in the neck, chest and hands. After being rushed to the local ED, the bishop was soon transported to a Level I trauma center where he was prepped to undergo several procedures to save his life.

Case Management Impact

Assigned to the case soon after the incident, Stephanie closely managed the treatment and recovery of the bishop. She worked closely with the hospital staff to ensure he received timely and appropriate medical care. She also obtained all medical records, clarification of diagnosis and treatment plan so the adjuster and employer could be updated about projected medical costs, recovery time frames, and estimates for return to work and maximum medical improvement. As the bishop began to progress in recovery, Stephanie made sure to directly communicate with the trauma center’s case managers to ensure the bishop’s safe transfer to a skilled nursing facility (SNF) within network. To avoid a delay in discharge from hospital to SNF, Stephanie established a rapport with the bishop’s attorney and family, going over care plan details and suggesting best strategies to ensure the bishop’s recovery.

Outcome

Stephanie’s ability to use all appropriate resources not only helped save the bishop’s life, but put him on a path to optimal recovery. He now receives outpatient care at home, just 10 months after the incident. Her efforts also resulted in significant cost savings on home care and durable medical equipment and avoidance of post-operative complications yielded an approximate ROI of 4:1.