Improving Hospital Case Management Care Transitions: Discharge Planning Through Transition to Community

Bernadette Benta

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This webinar will discuss the foundation of best-practice discharge planning for the RN Case Manager and Social Work Case Manager in the hospital. Also, the proposed changes to the Conditions of Participation: Discharge Planning by CMS will be reviewed.

Why Should You Attend:

Discharge planning has become more than just the movement of the patient out of the hospital. It is a “process” that starts at the point of admission and/or preadmission and transitions beyond discharge. The Center for Medicare and Medicaid Services (CMS) has recently added more “teeth” to the process in their proposed rules. This webinar will discuss the foundation of best-practice discharge planning for the RN Case Manager and Social Work Case Manager in the hospital. Additionally, the proposed changes to the Conditions of Participation: Discharge Planning by CMS will be reviewed.

Handoff planning, a newer term, describes the transition of your acute care patients to post-acute care providers. Included will be best-practice strategies for safely transitioning your patients across the continuum of care, as well as supportive case management roles for discharge planning outcomes. Lastly engage other members of the interdisciplinary care team in the process of planning for the patient’s movement across the continuum including internal and external care providers. Transitional planning is no longer a destination but a process! Learn how to ensure that your processes address the complexities of the new healthcare environment.

Areas Covered in the Webinar:

  • Transitional planning as a process
  • CMS’s transitional care management services
  • Case management transitions
  • Role of RN case manager and social work case manager in discharge planning
  • The admission assessment role in the discharge plan
  • Triggers for social work consults in complex discharge planning
  • Supportive case management roles for discharge planning: perioperative case manage, complex discharge planning case manager, case management assistant
  • Influences on transitional planning
  • Discharge planning compliance
  • Proposed changes for Conditions of Participation: discharge planning from CMS
  • Communicating across the continuum of care
  • The interdisciplinary impact on transitional planning
  • The outcomes dashboard for discharge planning

Who Will Benefit:

  • Directors of Case Management
  • RN Case Managers
  • Social Work Case Managers
  • Directors of Finance
  • Directors of Social Work
  • Physician Advisors
  • Chief Medical Officers
  • Any Executive Responsible for Case Management
Webinar Events
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Training CD-DVD

Physical CD-DVD of recorded session will be despatched after 72 hrs on completion of payment


Recorded video

Recorded video session



Speaker: Bernadette Benta , Division Chief, Maryland Department of Health

Bernadette. A Benta, MSHA, BSN, RN is a Strategic Leader and Subject Matter Expert with twenty years of Operational experience in Care Management , Utilization Review and also works to develop Population Management programs.

She is a seasoned Consultant on both in Acute Care hospitals, Managed Care Organizations and serves as a Clinical Liaison of for Revenue Management programs. Ms. Benta possesses expert knowledge of Medicare and state-specific Medicaid knowledge, and does some does some SME work for the government. She has proven experience in building departments from the ground up and improving process in both payer and health system settings and identifying trends which impact service delivery for quality improvement and solutions to non-standard requests and problems. Seasoned Nationwide Healthcare consultant.


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