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Discharge Planning: Proposed Changes Six Standards

It was only a year ago that CMS published the final discharge planning worksheet and a little more than two years ago when the hospital discharge planning standards were totally rewritten. They were 39-pages long and the number of standards decreased from 24 to 13.

Now CMS is proposing 20 pages of changes to the discharge planning standards and process. Once they’re final, CMS will add interpretive guidelines and publish them on this page and in the Federal Register.

There is a 60-day comment period. CMS will review the comments and then issue the final regulations.

Webinar on the changes

AHC Media is conducting a webinar covering the changes. For cost information and to register contact customer services at (800) 688-2421.

These regulations are aimed at helping to prevent unnecessary readmissions. Reducing hospital readmission helps minimize patient complications, improves the safety and quality of care, helps lower healthcare costs, and leads to reduced penalties from unnecessary readmissions. There are 2,680 hospitals that have forfeited $420 million because of their higher readmission rates. CMS notes there are too many instances where patients did not know their diagnosis, their current medications or their side effects.

CMS says hospitals, including critical access hospitals, need to improve their focus on behavioral health patients and those with substance-abuse disorders. Hospitals should consider options that include telemedicine services. A federal law on telemedicine was passed in 2011.

CMS also says some hospitals do not have a thorough understanding of community services that impact the discharge planning process. The lack of collaboration and teamwork has resulted in unnecessary readmissions. Hospitals should consult with the Aging and Disability Resource Centers, the Centers for Independent Living, or the Substance Abuse Mental Health Services Administration’s treatment locator.

The proposed changes focus on the patient’s goals and preferences and they must be incorporated into the discharge planning process. Instead of the hospital preparing the discharge plan and presenting it to the patient, patients become active partners in planning their post-charge care.

The hospital’s discharge planning policy must be developed with input from the medical and nursing staff along with other relevant department such as social workers and discharge planners. It must be in writing and approved by the board.