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Q&A: Guiding End-of-life Decisions

Analysis  |  By Revenue Cycle Advisor  
   December 29, 2020

Ellen Fink-Samnick, MSW, ACSW, LCSW, CCM, CRP, of EFS Supervision Strategies LLC in Burke, Virginia shares four strategies.

A version of this article was first published December 23, 2020, by HCPro's Revenue Cycle Advisor, a sibling publication to HealthLeaders.

Q: What strategies should case managers employ when guiding patients in end-of-life decisions?

A: Today, amid the COVID-19 pandemic, end-of-life care has never been more relevant, says Ellen Fink-Samnick, MSW, ACSW, LCSW, CCM, CRP, of EFS Supervision Strategies LLC in Burke, Virginia. “I’ve long said that the ethical tenets that underlie our practice are constant, even though the real-life circumstances and events impacting them are ever-changing,” she says. “That is especially true in the context of end-of-life care, or as it is becoming known, life-limiting illnesses.”

In the new HCPro book End-of-Life Care for Case Management, Fink-Samnick identifies the four C’s to guide end-of-life decisions:

  • Capacity. To ensure capacity, the case manager should be able to determine whether the patient and others who are involved understand and are capable of making all needed plans and care decisions.
  • Competence. Case managers should ascertain that the patient is mentally sound to make necessary decisions regarding end-of-life care. Keep in mind that an individual’s competence is established according to legal standards and the court, not by medical or behavioral health professionals, says Fink-Samnick.
  • Coping. Care should be taken to ensure a plan is in place to support the patient’s emotional needs during this health journey.
  • Choice. The case managers should ensure that the patient and family members are given clear choices regarding all elements of the process, including care, planning, and any potential alternatives.

In addition to focusing on the four C’s, case managers should make sure that they have a strong command of the formal processes and legal issues governing end-of-life decisions. This means having a good working knowledge of key terms and legal documents (both federal and state) specific to end-of-life care as it relates to the populations they serve, says Fink-Samnick.

Revenue Cycle Advisor combines all of HCPro's Medicare regulatory and reimbursement resources into one handy and easy-to-access portal. News is not just repeated from other sources. It is analyzed by our Medicare experts so professionals can comprehend any new rule and regulatory updates thoroughly. Learn more.

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