I am a quality warrior! This fact means that my brain goes into overdrive when certain reports cross my radar. The latest intel to have this impact was ERCI’s 2025 list of Patient Safety Threats. My focus immediately focused on the #1 issue, “Dismissal of the Patient and Caregiver Voice”. As a social worker by education and licensure and board-certified professional case manager, I am responsible for mitigating this quality gap. I also happen to be a fierce industry disruptor courtesy of my Doctorate in Behavioral Health. My DBH colleagues and students will get this one, but I digress.
I am an enduring ethical, legal, and regulatory champion to my core. I have been digging deep into the research, writing about, and presenting on medical gaslighting and invalidation for the past year. The dismissal and devaluing of any patient and caregiver voice is clearly associated with this obstructor to care. Medical gaslighting’s connection to increased costs of care is significant with billions of dollars lost from delayed and missed diagnoses. Increased healthcare utilization has come from unnecessary hospitalizations, readmissions, treatment missteps, yielding poor health outcomes. Mortality rates are equally higher when a patient’s voice or that of their caregiver is ignored.
Yet, two other areas of concern stood out to me as I reviewed the list of other patient safety priorities on the ERCI list:
- #5. Caring for Veterans in non-military health settings
- #9. Inadequate coordination during patient discharge
These two issues speak loudly to all of my colleagues, but particularly those in my professional case management world.
Professional Obligations Matter
Colleagues frequently ask me, why I get so hot about our established resources of guidance (e.g., accreditation and credentialing requirements, standards of practice, codes of ethics) ”. Yes, the hashtag or #EthicsMatter has become my hallmark. However, the list of 2025 safety issues represent a clear and present danger for patients. Quality missteps and patient safety concerns mean case managers are not heeding their professional obligations to the practice principles that underlie our licensure, certification, and organizational accreditation. This action represents potential professional sanctions for breach of the very requirements that bolster our case management profession.
Standards of Practice
Those professionals who walk in the world of case management are accountable to assorted standards of practice and codes of professional conduct. The Case Management Society of America (CMSA) set the tone for these seminal documents, crafting the initial version in 1995. Updating of each version of the standards occurs through a formal vetting process that was completed in 2002, 2010, 2016, and 2022. The addition of Standard Q: DEIB and Health Equity yielded a revised version of the document in 2024.
The intent of the standards are simple: to “serve as a compass for all who practice case management. They stand as a blueprint for excellence in practice”. They are not meant to be prescriptive in intent. Instead, they serve as a guide for professional case managers and their organizations to define optimal practices for the industry that meet ethical, legal, and regulatory guidelines and requirements. The relevant standards of practice by CMSA that address these patient safety realities include:
D. Ethics
E. Advocacy
G. Resource management
I. Client selection
J. Client assessment
K. Identification of care needs and opportunities
L. Planning
M. Facilitation, coordination, and collaboration
N. Monitoring
O. Outcomes
P. Closure of professional case management services
Q. DEIB and health equity
Each standard details clear guidance for the workforce in each of these critical areas of case management practice.
Licensure and Certification Requirements
Case managers have a primary responsibility to the licensure and scope of practice that underlies their professional discipline, whether in counseling, medicine, nursing, occupational, physical, respiratory or vocational therapy, social work or other qualified disciplines to practice (CMSA Standard A. Qualifications). Yet, we are then responsible to our case management credentialing, which is often dependent on this primary licensure.
Our credentialing entities prioritize the importance of critical competencies for their certificants through dedicated resources. The Code of Professional Conduct for Case Managers authored by The Commission for Case Manager Certification (CCMC) details keenly defined ethical standards, rules, procedures, and penalties for the workforce. The document’s Preamble sets a critical tone by defining case management as “a professional, collaborative, and interdisciplinary practice guided by the Code of Professional Conduct (the Code)”. The resource goes on to further denote the main purpose of the code; “to protect the public”. While the guidelines provided are advisory in nature, they still set a professional standard to which all board-certified case managers are held accountable.
The American Case Management Association (ACMA)’s Scope of Services and Standards of Practice also define clear competencies for practice. This resource also aligns with the association’s Accredited Case Managers Credentialing Exams, which have oversight by the National Board for Case Management:
Relevant Scope of Services, including but not limited to::
- Assessment
- Care coordination
- Facilitation
- Transition management competencies
- Longitudinal care management
- Identification
- Implementation
Relevant Standards of Practice, including but not limited to:
- Accountability
- Advocacy
- Resource management
Organizational Case Management Accreditation
Attention is also paid to these critical domains of practice by each of the entities that are tasked with providing, regulating, and monitoring of organizational case management accreditation. These include NCQA, URAC, and ANCC’s Magnet Recognition Program. The agencies define strict compliance requirements and standards for case management practice, as well as for the entities by which they recognize certification through.
The workforce should remain aware of the following:
Note: As of January 1, 2024, Magnet Status Recognition only accepts certifications accredited by the Accreditation Board for Specialty Nursing Certification (ABSNC) or the National Commission Certifying Agencies (NCCA). Included are ANCC’s Nursing Case Management board certification (CMGT-BC) and the Commission for Case Management Certification’s Board-Certified Case Management Credential (CCM).
The Bottom Line
Case managers have a critical role in ensuring compliance with the ethical, legal, and regulatory standards and requirements that underlie our practice. Each one of the established resources of guidance for case management prioritize our professional obligations to advocate for, monitor, and ensure patient safety; public protection remain a priority. They also heed every case manager’s accountability to the industry’s Quality North Star of the Quintuple Aim: patient- and family-centric care rendered at the right time, for the right cost, by professionals who embrace the work, and delivered in a way that is equitable and accessible for all.
ERCI’s Top 10 Patient Safety List for 2025 should be a call to action by every healthcare organization with attention from every case management leader and their teams. How will you and your organization step up to mitigate these gaps in quality and care?
Ellen's Interprofessional Insights 