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a h are your independent healthcare choice, • Inpatient & outpatient statistical report—by service and location • Specialty services—consults, procedures, and diagnostic services • ER trips—by service and location • Utilization Review—by disease classification • Reports of all catastrophic claims incurred—any amount greater than $25,000 Case Management NaphCare provides Case Management and Utilization Review efforts for hospitalized inmates. We recognize the value of on-site nurses in the facilitation of care in the hospital setting; our nurses are dedicated to and have extensive expertise in the above areas. Responsibilities for on-site nurses in the hospital setting inlcude the following: • Assistance with direct admissions—prevents lengthy & costly emergency room visits • Discharge planning—ensures that all medical needs are met prior to discharge • Increased communication between medical disciplines during complex hospital stays • Establishment of collaborative long & short term goals for treatment • Discharge planning—use of formulary drugs • Optimization of infirmary beds—ensures proper assignment & level of care for inmates NaphCare's discharge and release team has the off-site healthcare experience needed to best meet inmates' needs. At the onset of care for each hospitalization, our utilization nurses prepare a customized plan. NaphCare's nurses are well informed of all available infirmary services and health service units within the prison system, as well as community resources in your region, allowing our personnel to optimize internal resources while simultaneously minimizing off-site trips. For provision of continuity of care, discharge summary information and instructions are provided to inmate healthcare staff. Following off-site treatment, inmates returning to the correctional facility return with documentation of treatment received in the form of a discharge summary, consult follow-up, or other progress note. All patients returning from an inpatient hospital stay are evaluated by a registered nurse prior to placement in the general population. In addition to this evaluation, inmates meet with an on- site provider who ensures appropriate orders and follow-up. Quality Initiatives NaphCare's Utilization Management Department conducts a monthly Utilization Management Committee Meeting to identify and implement quality inititatives such as the readmission review process. Research is performed and shared with the committee, resulting in implementation of quality improvement processes. When necessary, cases are referred backto the Chief Medical Officer for peer review and further recommendations for quality improvement. Utilization Management education is an ongoing process throughout the life of the contract. CENTRALIZED MEDICAL SCHEDULING We coordinate off-site appointments for the SAJ through the Medical Scheduling Department at our corporate office. By using TechCore®, we facilitate the exchange of important healthcare and financial information between the correctional facility and NaphCare. This system has several key features that are beneficial to Santa Ana: • Customized reporting • Ability to track inmate healthcare (off-site specialty appointment by type) Inmate Medical Services City of Santa Ana 25F-77 RFP No. 17-051 78