Workers' Comp

Off the Streets and Safe from COVID


Field Case Management

Rebecca Almskog, RN, BSN, CCM

Rebecca Almskog is a field case manager with 25 years of nursing experience in the Denver-area. She put her critical thinking skills and knowledge of local resources to work when assigned to a case involving a homeless injured employee with several comorbidities who was on the streets during the height of the COVID-19 pandemic.

The Case

A 64-year-old employee working at a grocery store distribution center slipped on ice while inspecting a truck entering the facility. She was diagnosed with a stable pelvic fracture, which required rest and stabilization. Soon after being assigned to the case, Almskog learned the claimant had been living in her car at the time of the injury and worked on establishing trust with the injured employee, who was initially reluctant to reveal her homelessness and staying at a friend’s house during recovery. Soon after, though, Almskog noticed that the claimant's daily hygiene habits began to diminish and realized her current living conditions were not conducive to recovery.

Case Management Impact

Almskog used her critical thinking skills to determine how to keep the injured employee, who was living with several comorbidities, off the streets and in a safe environment to heal. She managed to have the woman placed at a skilled nursing facility, where she would receive therapy five days a week and have her medication regimen and glucose regularly checked. The injured employee thrived in the environment and was recovering well, but as the COVID-19 pandemic hit the U.S., the facility needed to open beds and planned to discharge the woman early. With no place to go and no modified duty available from her employer, the woman was headed back to the streets. Once again, Almskog began looking for alternatives. When she learned the claimant had a brother in Texas, Almskog called the sibling who agreed to let his sister stay with him, if she could get to Texas. She then contacted the adjuster who agreed to settle the claim and Almskog arranged the trip to Texas. When discharged from the facility, the claimant had one pair of pajamas and her work uniform. The case manager procured clothes and a warm coat before the employee flew to Texas.


Today, the woman is healthy and happily retired living in her own apartment in Texas. Almskog’s actions on this file resulted in an ROI of 3.10 cost savings, but most importantly, she likely saved a life.


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