Case Management Employee Spotlight

For Karen Apsey, serving as a case manager at a Select Medical critical illness recovery hospital is a demanding yet rewarding career.

Her job is never boring because “every patient is different. Every day is a new adventure.”

The one constant, she said, is the personal fulfillment from helping patients and families who are often in the throes of a crisis.

Apsey works at Select Specialty Hospital – Saginaw. It’s her first long-term acute care setting. Previously, she worked at several Michigan short-term acute care hospitals.

Within two days of admission at any Select Specialty Hospital, a care team – including a case manager – meets with the patient and/or their caregivers. The goal is to learn more about that patient’s unique situation and goals, communicate what the patient can expect during their stay and work together on a care plan.

The case manager then coordinates care, guides patients and their families through the health care system, ensures continuity of care and advocates for their needs. One of their most important responsibilities is looking ahead to plan for discharge – determining and meeting a patient’s needs after they leave the hospital, both medical and social service needs.

“I find out where they were, where they are now, what will their needs be when they leave,” Apsey said. “Can they go back to their previous living situation? Many times it’s a no. Will they need inpatient rehabilitation, can they go home, will they need a skilled nursing facility or a walker or a wheelchair or oxygen or CPAP (a continuous positive airway pressure machine)? We figure out what the needs will be and work to meet them.”

As an example, Apsey recalls a patient who came to her hospital with a wound so severe, the infection had spread to his bones. Two years earlier, the patient suffered a severed spinal cord that left him paralyzed from the waist down; the result of a tornado that hit his home and pinned him under the walls.

He made it back home after his initial injuries, but came to Select Specialty Hospital for care for the deep wound on his backside.

Shortly after admission, the family met with Apsey, who asked them a series of questions.

Where do you live? Who lives with you? Describe the inside and outside of your home. What equipment do you have? What has been working well and what has not?

The patient explained that he couldn’t move well in bed, and the wound – a pressure ulcer – was evidence of that. For six months, he and his family were trying to get their insurance company to approve a higher-quality mattress as well as a trapeze bar above the bed that would allow him to more easily move in bed.

Throughout the patient’s five-week hospital stay, Apsey was working behind the scenes. She kept his family updated on his progress and milestones, and sent reports to his insurance company that are required to continue coverage. As the patient approached discharge, she arranged for home care and made sure his family understood how to help him with his care.

And, she had already taken care of the cumbersome process of submitting the documents needed for his insurance company to approve the new mattress and trapeze bar.

Both were waiting for the patient when he got back home.

The patient was grateful, and Apsey knew she made a difference.

“I enjoy working with the patients, their families and the entire health care team on creating a discharge plan that meets the needs of the patient,” Apsey said.