Upper management does not value the expertise of those they hire. Staff, with practical experience, is not valued in the decision making process. Ideal results and numbers are set as anticipated results without considering the human factor that should be a part of decision making equations such as high census times and sick calls when dictating staffing ratios, etc. Stretching the truth or exaggerating when it comes to an individual meeting inpatient criteria is common. Reviewers have been told to "make the patient meet." Communication is poor throughout the organization. Lack of preparation and planning is frequent. Case Managers within Prime are paid below market value in the industry, which further reflexes the low value that is placed on the discipline.
Utilization Review, a primary function of Case Management, is being transferred to "medically-trained personnel" in India. Yet the local CM are still being held responsible for the length of stay and other CM specific data within their individual facilities. This new practice will be detrimental to Prime and Prime facilities.