A skilled nursing versus home health decision, made by the patient under Medicare's discharge planning rules despite a family disagreement, drives the NU433 Unit 5 case study. Searches like "nu 433 unit 5 assignment example", "nu433 unit 5 sample" and "nu433 unit 5 example" land here.
Home to a Second-Floor Apartment or a Nursing Facility: A Discharge Planning Case Where the Patient Chose
[Student Name]
Purdue University Global
NU433: Case Management Across the Continuum of Care
Unit 5 Assignment
[Instructor Name]
[Date]
Composite patient and family written as a model document. No real person is described.
Case Summary
Nonoperative pubic ramus fracture after a fall at home. Inpatient day 4. Walking 40 feet with a walker and moderate help; no stairs yet. Decision-making capacity intact. Traditional Medicare, with a qualifying three-day inpatient stay.
Day-One Screen
Flagged high risk for a complex discharge: lives alone, new mobility limits, 14 steps to her door. Planning started that day.
Assessment
Function: moderate help for transfers and walking.
Cognition: intact; she recalled her medications and the fall clearly.
Home: second-floor apartment, no elevator, bathtub without grab bars.
Caregiver: daughter two hours away, works full time; a neighbor checks on her.
Finances: fixed income; no long-term care insurance.
Her goal, in her words: "I want to sleep in my own bed."
Options
Inpatient rehabilitation: dropped, because she cannot yet tolerate about three hours of therapy a day. Skilled nursing facility: kept; daily therapy and nursing, covered for a limited period after her qualifying stay. Home with home health: kept, with risks stated plainly. She cannot yet manage 14 stairs, and Medicare does not pay for the daily personal care she would need at first.
The Family Meeting
Her daughter: "I can't be there, and I can't lose her to another fall." The patient: "I'm not going to a home to die." The case manager's role was to lay out the options, their risks and their costs, not to decide. Respecting the choices of a patient with capacity is central to the ethics of care (Beauchamp & Childress, 2019). She chose a 14-day skilled nursing stay, framed by her as a step toward home rather than instead of it.
The Plan
She was given a list of local facilities with their star ratings and chose one near her daughter's route to visit. The Important Message from Medicare notices were delivered and explained. The handoff to the facility included her therapy notes, her goal of walking stairs, weight-bearing orders, medication list, fall history and her daughter's contact. The case manager called the facility the next day to confirm arrival (Case Management Society of America, 2022). A discharge goal written into the facility plan, walking 14 stairs with a rail, gives both her and the facility a measure for when home becomes safe. The case manager also referred her to home health for the move home, so that the second transition is planned before the first one happens.
References
Beauchamp, T. L., & Childress, J. F. (2019). Principles of biomedical ethics (8th ed.). Oxford University Press.
Case Management Society of America. (2022). Standards of practice for case management. Case Management Society of America.
How this NU433 Unit 5 example is structured
Discharge planning is shown starting at admission, the case's first point. The day-one screen flags her as high risk for a complex discharge, living alone with new mobility limits, and the assessment table follows from it. The options section is written so each choice is eliminated or kept for a stated reason: inpatient rehabilitation drops out because she cannot yet tolerate about three hours of therapy a day, and home stays on the list with its risks stated plainly: the stairs are not yet manageable, and Medicare does not pay for the daily personal care she would need. The family meeting is summarized with both positions in their own words and the case manager's role as facilitator, not decider. Her capacity is documented, and the choice is recorded as hers. The facility handoff lists what the receiving team needs on arrival.
Get an NU433 Unit 5 example written to your instructions
Discharge cases vary in setting and payer, so the model follows yours: include the case as written, any required format and the rubric for Unit 5, and note the patient's coverage if the case gives it. Expect the case study within 24-48h, patient choice documented and every option reasoned, free on your first request. The paper above is an original model document written by our desk, not a submitted student paper and not an official Purdue University Global document.
NU433 Unit 5 questions, answered
What notices does a Medicare discharge involve?
For Medicare inpatients, including those in Medicare Advantage plans, the Important Message from Medicare is delivered within two days of admission and again no more than two days before discharge, explaining appeal rights. Observation patients receive the MOON instead. The sample times both IM deliveries. Other payers have their own rules, so check the case's coverage first.
Can a case manager override a patient's choice if it seems unsafe?
Not when the patient has decision-making capacity. The case manager's job is to present options, explain risks honestly and document the discussion, including any choice the team disagrees with. Where capacity is in doubt, a formal assessment comes first. The sample documents capacity before recording her choice, which is what protects both patient and nurse.
Why not inpatient rehabilitation for a fracture?
Inpatient rehabilitation facilities generally expect patients to tolerate an intensive program, commonly described as about three hours of therapy a day, five days a week. A frail patient who walks 40 feet with help may not meet that yet, which points to a skilled nursing stay. Your case may differ, so the reasoning matters more than the destination.