Doctors might know what's best for their patients, but patients don't always choose to follow that advice. Over these past few issues, CMM has talked about CMS' new suggested best practices, which were included in revisions to the discharge planning section of the CMS State Operations Manual. These new recommendations call on facilities to carefully investigate patients' refusals to heed medical advice and document their reasons for doing so. However, there is more you can do when a patient balks at a physician's instructions, says Wendy De Vreugd, RN, BSN, PHN, FNP, CCDS, MBA, senior director of case management at West Region Kindred Healthcare, Hospital Division.
Observation or inpatient? It sounds like a simple question, but it continues to be a sticky area for most facilities. If your organization is having trouble correctly assigning every patient, you're not alone.
