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CMS has discharge planning standards in the hospital conditions of participation. These start at tag number 799 and go to tag 843. These were completely rewritten and went into effect July 19, 2013, and went from 24 to 13 standards. CMS then finalized the discharge planning standard on Nov. 26, 2014. This will result in an increased focus on discharge planning for hospitals having a validation or certification survey. There are also a significant number of deficiencies in the discharge planning process. CMS now publishes these on a quarterly basis. In the April 15, 2015, report there were 414 deficiencies. Also, hospitals are financially penalized by CMS for having a higher than average readmission rate.
The American Hospital Association has released a set of tools to help improve the hospital discharge process and transition in care process. The resources include case examples from five different hospitals. Each hospital is unique and what processes work for one hospital but not necessarily work for all hospitals. Hospitals should evaluate their specific data in designing the discharge process. The discharge planning tools focus on assisting physicians and staff to optimize a patient’s health as they plan the discharge process from hospital to home. The document is 32 pages and titled “Private-Sector Hospital Discharge Tools: Samples of Hospital Discharge Planning Tools that Strive to Improve Transitions to Post-acute Care and Reduce Readmissions.”
There currently is not a standardized hospital discharge tool. However, HHS has developed a standardized patient assessment tool. This includes the Continuity Assessment Record and Evaluation Tool and the B-CARE tool. However, this tool does not assist in determining the best setting for the patient to go to when discharged from the hospital. Hospital discharge planning tools differ from patient assessment tools. This report focuses on the discharge planning process.
The CMS hospital discharge planning worksheet is here. To find it quickly, scroll down to Nov. 26, 2014.