Q&A: Adjusting to the updated DND form

Q: The deadline for implementing the updated Detailed Notice of Discharge (DND) form was April 1. What are the most important changes that our staff should be aware of as we move to the updated form?

A: The changes for the DND are consistent with CMS’ goal of patient empowerment in the discharge process. Several changes were made and are worth reviewing, as the case manager is most likely the staff member with the knowledge and expertise to complete this section of the form. The additional DND statement begins with the sentence, “We have reviewed your case and decided that Medicare coverage of your hospital stay should end.” The form then lists the facts used to make the decision:

• Detailed explanation of why the patient’s hospital stay is no longer covered, and the specific Medicare coverage rules and policies used to make this decision
• Plan policy, provision, or rationale used in making the decision (health plans only)

This is another example of a new requirement possibly leading to an increased workload for staff. Case management budgets have already been established for this year, but the possibility of an increased workload for case managers may create a need for additional staff. (Note that these changes were announced by CMS after most organizations had finalized this year’s budget.)

Editor’s Note: This answer was originally published in a column in the March issue of Case Management Monthly.