For many injured workers, the road to recovery can be complicated, often filled with logistical challenges and medical concerns. At Madonna Rehabilitation Hospitals, nurse case managers play a crucial role in ensuring a seamless transition from hospitalization to recovery, acting as the vital link between patients, healthcare providers, and insurance companies. One such Madonna nurse case manager, Deborah Sheehy, sheds light on her role and how she coordinates the many moving parts of a patient’s rehabilitation journey.
“Communication is absolutely key,” she said. “I keep in contact with the workers’ compensation team, which includes work comp case managers, insurance adjusters, and work comp physicians. My job is to make sure we’re all aligned in terms of the patient’s progress, insurance authorizations, and necessary accommodations.”
Sheehy noted effective case management often begins even before an injured worker comes to Madonna.
“I call the workers’ comp case worker beforehand—sometimes even before the patient arrives—to gather background information,” she said. “I ask about the injury, any concerns from the patient or family, and the main focus of their care. I also inquire about the patient’s goals for their stay. Once I have this information, I email the Madonna care team so the primaries are informed before the patient arrives. I think that sets us off on the right foot, and we start building trust with the work comp team, the patient and his or her family.”
A significant part of Sheehy’s work also involves securing approvals for medical treatments, equipment, and therapy services. Sheehy ensures that every necessary insurance authorization is obtained before proceeding with treatments, avoiding liability concerns and potential setbacks in care.
“We want to get those balls rolling right away, so there’s not a time delay,” she said. “As soon as we know a patient will need a home modifications or special equipment, we get the paperwork in immediately. We are planning for discharge from the get-go, even if it might be months away.”
Beyond logistics, Sheehy emphasized the importance of meeting patients where they are in their recovery. Work re-entry is a significant goal at Madonna, but she added that it must align with the patient’s physical and psychological readiness.
“Some patients are eager to return to work, while others know they won’t be able to,” Sheehy said. “We respect their wishes and adjust our approach accordingly.”
Overall, she added that Madonna’s comprehensive, patient-centered approach yields strong results, making it a preferred choice for workers’ compensation cases.
“We’re aggressive with therapy, but also thorough,” Sheehy said. “Our goal is to restore as much independence as possible, helping patients return to their communities and workplaces safely and successfully.”
The work of a nurse case manager is often behind the scenes, but it is indispensable. Their ability to coordinate care, anticipate challenges, and advocate for patients ensures that every individual has the best possible chance at recovery. Through meticulous planning, clear communication, and unwavering dedication, Sheehy and her colleagues play a crucial role in turning recovery goals into reality.
Coordinating Care: The Role of the Nurse Case Manager
