Transitions of Care
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Chronic Wounds: A Case Manager’s Challenge in the Transition from Acute to Community-Based Care

BY RON BILLANO ORDONA, DNP, FNP-BC, GS-C, WCC
In an article I wrote for Nursing Clinics of America, I highlighted the critical role of effective care transitions for chronic wound patients, emphasizing the need for robust communication between acute, skilled nursing and community-based care settings. By focusing on nurse and nurse practitioner (NP)-led community-based initiatives and strategies that reduce hospital readmissions, I am advocating for comprehensive discharge planning and sustained follow-up care.

Rural Health
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Enhancing Rural Healthcare in Illinois: A Comprehensive Strategy by the Illinois Nurses Foundation

BY SUSAN Y. SWART, EDD, MS, RN, CAE
The Illinois Nurses Foundation is spearheading a transformative initiative to address the critical healthcare disparities that pervade rural areas in Illinois. By launching the Rural Workforce Development Nurse Scholarship and preparing to introduce a separate retention program in early 2025, the foundation aims to create a robust and sustainable rural healthcare workforce.

Social Determinants of Health
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Doing the Nitty-Gritty–Using SDOH

BY PEGGY A. ROSSI, BSN, MPA
As someone who has done or taught discharge planning for many years, one key component that holds true for me today is that when discharge planning assessments are performed, especially on those very complex cases, they must be very comprehensive.

Rural Health
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Transitions of Care for Patients in Rural Communities

BY NANCY SKINNER, RN, CCM, CMGT-BC, ACM-RN, CMCN, FCM
Regardless of governmental data and descriptions, it is my belief that the term rural cannot be quantified by a single descriptor, zip code, town or area. Instead, it is important to realize that for our patients a rural residence represents a symphony of challenges and barriers that might impact their ability to achieve the highest level of health and function through and across the healthcare continuum.

Rural Health
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Is Living Rural Considered a Health Risk?

BY GARY WOLFE, RN, CCM, FCM
Have you ever given any thought to the idea that where you live may have a direct impact on your health outcomes? Probably not, because I don’t think many people think about their health and where they are living until they have significant health concerns or are retiring. People choose where they live based on a variety of issues: family, employment, economic factors, opportunities, education, etc. This article will examine the impact living in a rural area has on your health outcomes and some of the influencing factors.

Association News
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Elevating Case Management Through Education, Networking and Community: CMSA in 2025

In a profession as dynamic and vital as case management, staying informed, connected and prepared is key to providing exceptional care. Whether it’s fostering meaningful connections with peers, building advanced skills or exploring innovative practices, the Case Management Society of America (CMSA) continues to empower case managers to thrive in their careers and make a lasting impact.

Elder Care
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Program for All-Inclusive Care for the Elderly

BY LISA SIMMONS-FIELDS, DNP, MSA, RN, CCM, CPHQ, FCM, AND ANNE LEWIS
Case managers working with aging populations need to be able to link patients with resources in the community. The Program of All-Inclusive Care for the Elderly (PACE®) is a comprehensive, high-touch provider-based health plan for frail, complex individuals who require a nursing home level of care.

Hospice Care
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The State of Hospice

BY SARA DADO, BSW, MSW, LCSW
November has always been one of my favorite months of the year. Partially because of fall and Thanksgiving and family time and all the things that come along with preparing for the holiday season. But also because it is National Hospice and Palliative Care Month, a time of year when the focus turns to the sector of our healthcare system where much of my professional career has been spent.

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