The Basics

This standard can be considered an elaboration of Core 28 (v. 3.0), which requires organizations to provide employees with tools appropriate to their jobs.  This case management standard adds specificity to the Core requirement, mandating that CM organizations provide tools and information to their case management staff to collect information necessary to the CM process and participate in the quality management process. Everybody involved in patient care, not necessarily only case managers, needs to have access to the appropriate tools and needs to be familiar with all the tools offered by the organization.

What kinds of tools are we talking about here?  They could be computerized tools for data collection, but also could be lists (providers and other resources), paper forms for gathering data, financial information, and case management plans.

URAC Accreditation Tips

For purposes of submitting to AccreditNet, the documentation should be a broad sampling of these tools, perhaps screen shots from computerized tools and copies of forms and lists.

The onsite review will focus on reviewing case files for evidence of use of these tools, and interviews and observations of the case management staff members to see how that use the tools and to assure that the tools are readily available to staff members.

This standard carries a weight of 3, and all the elements are secondary.