Q&A: Adapting to CMS' discharge planning rules

January 15, 2020
Medicare Web

Q: Do you have advice for case managers following the recent implementation of CMS’ discharge planning rule?

A: This past September, CMS issued a final rule that is intended to allow patients to make “informed decisions” during the discharge planning process.

The new regulations became effective on November 29, so organizations should be well on their way to establishing revised protocol.

Here are a few suggestions for dealing with the changes:

  • Engage in ongoing dialogue with patients about their next-step choices. CMS wants patients to be actively involved in the decision-making process, so case managers must decide if the doctor’s recommendations align with the patient’s treatment goals.
  • Consider implanting electronic predictive analysis. CMS’ new rule calls for hospitals to identify high-risk patients at an early stage of hospitalization and provide a discharge planning evaluation for those patients. One way to make this process easier is to implement a program that will examine multiple factors to identify at-risk patients and predict their likely socio-economic needs.
  • Offer more detailed information about postacute facility options in a convenient manner. Patients can find information about SNFs and HHAs on the CMS Compare sites, but no rating system exists for LTACHs and IRFs. The case manager must convey this information so it can be easily understood by patients.

For more information, see Case Management Monthly.

Related Topics: 
Ask the Expert