Case management in long-term care settings

The health care system is a changing environment strongly influenced by the rapid growth of managed care. This change is seen in all aspects of U.S. health care, including extended care settings. Many extended care facilities (ECFs) are forced to review how they deliver care. These facilities are receiving more acutely ill residents as a result of managed care requirements that acute care settings discharge patients much earlier than in the past. These facilities essentially are replacing the hospitals of the 1970s and '80s.