News

New Jersey Case Manager Fights “Tooth and Nail” for Patients

cm2018-blog-featureMarie Ruiz, case manager and lead assessment coordinator at Jefferson Health Care Center, is a fierce advocate for her patients. But she doesn’t always win.

In June, an elderly patient spent approximately two weeks at the Sewell, New Jersey skilled nursing facility following spinal surgery. When her insurance ended, the patient wasn’t ready to return home. She lived alone in a one-story house with steps at the entry. Ruiz says the patient’s endurance and balance were poor and agreed that she would benefit from additional therapy under their care.

marie-ruiz“We fought tooth and nail for her to stay,” she says. “Our efforts were not successful and she went home and fell a day later. It confirmed we were right and she was readmitted. When she did go home again, it was a better outcome.

“You don’t win every battle but I know I did my best. The patient and family were grateful for us. We know the patient believed in us.”

Patients spend an average of two to three weeks at Jefferson, often following surgery or a hospital stay. During that time, Ruiz develops care plans, answers questions about health benefits, and facilitates the insurance and appeals processes.

“It’s very detailed, time-sensitive work but I’m still a nurse at heart,” she says. “I like to get to know my patients, what brought them here and what barriers they will have to overcome when they go home.”

Ruiz is working on her master’s degree in public health and eventually would like to work for a hospital and work with veterans. Her husband is in the military and was awarded the Purple Heart after he was injured in Afghanistan in 2010. “It’s often difficult for veterans to bridge back into home life after they come back from the war,” she says. “This is an issue close to my heart.”

Desiree Rhoda, director of social work at Jefferson Health Care Center, says: “Marie goes above and beyond daily for her patients. She takes extra time to explain their insurance benefits, appeal rights and processes, and will even assist the patient and family with phone calls. Marie deserves to be recognized because she is exceptional.”

Case managers are often the unsung heroes in a patient’s recovery. In conjunction with National Case Management Week, we asked for nominations for outstanding case managers who deserve some extra recognition. We continue to share the stories of some of the case managers who have been nominated.

Posted on Nov 22, 2018 8:58:50 AM by Monica Ginsburg in casemanagement, in Post-Acute, in Hospitals

Monica Ginsburg

Written by Monica Ginsburg

Monica Ginsburg is a Chicago-based freelancer who regularly writes about healthcare, technology and entrepreneurship.