CMS proposes overhaul to discharge planning, requires follow-up procedures

The Centers for Medicare and Medicaid Services on Monday proposed new rules to discharge planning requirements for long-term care hospitals, inpatient rehabilitation facilities, critical access hospitals and home health agencies.

Under the proposed rule, hospitals and critical access hospitals are required to develop a discharge plan within 24 hours of admission or registration and complete a discharge plan before the patient goes home or is transferred to another facility.

CMS hopes to improve outcomes by reducing complications and readmissions.

[Also: CMS to cut Medicare payments to home health agencies by 1.4%]

The proposed rule also takes into account the Improving Medicare Post-Acute Care Transformation Act of 2014 requiring hospitals and providers to use data on quality and resource use measures when patients are being discharged and to include their preferences.

"CMS is proposing a simple but key change that will make it easier for people to take charge of their own health care. If this policy is adopted, individuals will be asked what's most important to them as they choose the next step in their care – whether it is a nursing home or home care," said CMS Acting Administrator Andy Slavitt.

The rule applies to all inpatients and certain types of outpatients, including patients receiving observation services; those who are undergoing surgery or other same-day procedures in which anesthesia or moderate sedation is used; and emergency department patients who have been identified as needing a discharge plan.

Hospitals and critical access hospitals are also be required to provide discharge instructions to patients, have a process for medication management and have a post-discharge follow up process.

For patients who are transferred to another facility, specific medical information is required to be sent to the receiving facility.

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Hospitals and critical access hospitals would be required to consider  the availability of non-healthcare services and community-based providers that may be available to patients post-discharge. There is also a mandate that they use and share data, including data on quality and resource use measures.

"This rule puts the patient and their caregivers at the center of care delivery," said CMS Deputy Administrator and Chief Medical Officer Patrick Conway. "Patients will receive discharge instructions, based on their goals and preferences, that clearly communicate what medications and other follow-up is needed after discharge, and pertinent medical information will be communicated to providers who care for the patient after discharge. This leads to better care, smarter spending, and healthier people."

There is a 60 day comment period on the proposed rule.

Twitter: @SusanJMorse