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Total Case Management is a new model of Case Management that promotes "intentional patient navigation" for better healthcare services for patients receiving rural healthcare services. This model increases patient satisfaction, increases utilization of services, reduces insurance denials, and increases revenue. A true "WIN/WIN", supporting patients and generating revenue that creates sustainability for rural healthcare settings. Total Case Management offers solutions that were implemented at a Texas rural hospital on the brink of closure which was turned around within 2 years with a net of $2.5 million dollars. Learning Objectives: 1. Focus on ED Admissions Rates - Open the door to Qualified Admissions 2. Intentional Patient Navigation - Managing Patient Days to Support Patients and Utilization of Services 3. How to Implement a Total Case Management Program