Follow ACMA
Twitter Facebook Linkedin
v
GO
Updates & Calls to ActionMake a Donation
PUBLIC POLICY UPDATES

CMS Announces Final Discharge Planning Rule: Compliance due by Nov. 29


Posted on: 11/16/2019

On September 30, 2019, the Centers for Medicare and Medicaid Services (CMS) published a final rule to implement new discharge planning requirements for hospitals, critical access hospitals and post-acute care (PAC) services entities. Originally mandated by the Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act), the long-awaited action from CMS comes four years after the original proposal was published.

“Discharge planning is an important component of a successful transition from hospitals and PAC settings.” – CMS

Read the final discharge planning rule >>>

ACMA’s Overview and Quick Reference

ACMA has been following the rule’s development since it was first proposed back in November 2015. The final rule has been scaled back from the initial proposal to lessen the regulatory burden on covered entities and to facilitate a smooth transition to compliance. CMS also recognizes and values the efforts with Patients over Paperwork and has chosen not to “focus on prescriptive and burdensome process details, and more on patient outcomes and treatment preferences through the enhanced information exchange and innovative practice standards”. Ultimately, CMS has concluded that most covered entities have already implemented the rule in some form or fashion, and because of that, the agency is mandating compliance by November 29, 2019 (60 days after publication).

“The location to which a patient may be discharged should be based on the patient's clinical care requirements, available support network, and patient and caregiver treatment preferences and goals of care.”- CMS

5 Things to Know About the Rule:

1. A hospital’s discharge planning process must identify at-risk patients and hospitals must provide a timely discharge planning evaluation of patients, and update the evaluation and plan as needed. (The discharge planning evaluation must be documented in the patient’s medical record.)

2. A discharge planning evaluation must include an evaluation of a patient’s likely need for appropriate post-hospital services, including, but not limited to, skilled nursing (SNF), home health services (HHA), inpatient rehabilitation facility (IRF), long term acute care hospitals (LTCH), and non-health care services and community based care providers, and must also include a determination of the availability of the appropriate services as well as of the patient’s access to those services. CMS also recognizes situations may rise where patients prefer not to participate or refuse, and states this the declination or refusal is to be documented in the medical record as well.

3. Hospitals must assist patients, their families, or the patient’s representative in selecting a post-acute care provider by using and sharing patient-relevant data on quality measures and resource use measures of area services, including HHA, SNF, IRF, or LTCH data, and by providing a list of HHAs, SNFs, IRFs, or LTCHs that are available to the patient, that are participating in the Medicare program, and that serve the geographic area of the hospital or the geographic area requested by the patient. The hospital must also document in the patient’s medical record that the list was presented to the patient or to the patient’s representative. CMS expects hospitals to make best efforts in providing this information to align patient’s treatment goals and preferences. CMS also expects providers to preserve the expectation of freedom of choice for patients and their caregivers in selecting post acute services and providers where required.

4. Hospitals must discharge patients with all necessary medical information pertaining to the patient’s current course of illness and treatment, post-discharge goals of care, and treatment preferences to the appropriate post-acute care service providers or other practitioners responsible for the patient’s follow-up or ancillary care. This is not a new requirement, and patient discharge instructions are already required as a part of the medical record under Medical Record Services requirements in S482.24.

5. Hospitals must share with patients their medical records in a timely manner upon request and in a form or format that is easily accessible and readable.

What is CMS Saying?

“[This] rule puts patients in the driver’s seat of their care transitions and improves quality by requiring hospitals to provide patients access to information about PAC provider choices, including performance on important quality measures and resource-use measures – including measures related to the number of pressure ulcers in a given facility, the proportion of falls that lead to injury, and the number of readmissions back to the hospital.”

Read the CMS press release here: Statement on Discharge Planning Rule >>>

Return to Legislative Postings

Announcements

Compass 2020 Now Available!

Creating a case management team that is consistent and confident with ever-changing regulations and practice standards can be a daunting goal. However, it can be done with annually updated online training. Currently in use at over 1,500 facilities with more than 31,000 users, Compass courses are updated each year for case managers and physician advisors across multiple care settings. Streamline your onboarding while updating annual education around regulations and national standards of practice today. Compass 2020 is now available. Watch a video to learn more and subscribe now. >>>

In-Depth Learning Covering 9 Practice Settings

Network and collaborate with case managers from different practice settings at the 2020 ACMA National Conference, April 6-9, 2020 in Chicago. For each breakout session opportunity, you will have seven presentations to choose from. Hot topics will include homeless discharge planning, length of stay reduction, mental health, succession planning and care coordination for pediatrics—just to name a few.
View Sessions

ACMA Member Advantage: Prescription Savings Program

Did you know your ACMA membership provides your patients, family, friends and you a prescription discount benefit? You don't need prescription insurance to take advantage of this free cost-savings benefit. If you do have prescription coverage with your insurance, it sometimes pays to compare the two. You can access the digital card from your ACMA Member Site anytime. Get My Prescription Savings >>>

Save 20% on Affiliate Membership - Limited Time Only!

Reap the benefits of Affiliate Membership! Affiliate Membership benefits include visibility with your company's logo on the ACMA website, email promotion sent on your behalf to approximately 9,000 ACMA members, discounted pricing at upcoming ACMA conferences and more! Become an Affiliate Member today and save 20% on dues when you add an Affiliate Membership package to your 2020 National Conference booth purchase! Learn more about Affiliate Membership.

Register Now

*Search for "affiliate membership"

Case Management Administration Certification

The Case Management Administration Certification (CMAC) is designed to measure the competence of case management administrators, managers, supervisors and leaders, and is available to all professions. This level of expertise helps improve care transitions by ensuring a more robust discharge plan for patients to ensure length of stay reductions and readmissions. The application deadline is February 15 in order to test in April-June. Apply Today >>>

Accredited Case Manager Certification

The Accredited Case Manager (ACM) Certification is for health care delivery system case management professionals and tests core case management knowledge that is shared by nurse and social work case managers, as well as competency in the individual skills of each professional background. If you are not yet ACM certified, we encourage you to apply now and enhance your professional practice by putting the ACM credential after your name. The next application deadline is February 15 in order to test in April-June. Get Certified Today >>>

Physician Advisor Standards of Practice and Scope of Services Announced

The Association of Physician Leadership in Care Management (APLCM) releases formal standards to meet the current needs of case management, specifically, the changing and expanding Physician Advisor Role. APLCM worked collaboratively with the American Case Management Association to develop these standards. A formal announcement will be made at the ACMA/APLCM Leadership and Physician Advisor Conference on Friday, November 15 in Miami. Visit the APLCM webpage for more information. Press Release. >>>

American Case Management Association
11701 W. 36th St.
Little Rock, Arkansas 72211
Phone: 501-907-ACMA (2262)
Fax: 501-227-4247