OCMM-Evaluating the Level of Care across Healthcare Settings
At times, a Medical Director will have to review a case to determine what type of care a member needs and the appropriate setting in which to receive that care. This course discusses the level of care (LOC) and how that impacts the healthcare setting. This course examines the health care settings listed below and any accompanying Medicare and Medicaid Services (CMS) guidelines.
Acute Hospital Facility
Acute Inpatient Rehab (AIR)
Long-Term Acute Care (LTAC)
Skilled Nursing Facility (SNF)
Home Health Care (HHC)
Optum Care Management
Define level of care (LOC) and how that impacts the healthcare setting.
Describe the differences between Acute Hospital Facility, Acute IP Rehab (AIR), Long-Term Acute Care (LTAC), Skilled Nursing Facility (SNF), and Home Health Care (HHC).
Identify Centers for Medicare and Medicaid Services (CMS) guidelines for AIR, LTAC, SNF, and HHC.
Discuss letter requirements for adverse determinations.
Describe skilled nursing versus custodial care.
- 0.00 Attendance