Description

By: Laura Dixon and Toni G cesta 

The CMS COPs for Discharge Planning and Compliance with CMS Hospital and CAH CoPs 2021 update

The final rules for Discharge Planning arrived after a three-year wait! The Centers for Medicare and Medicaid Services (CMS) have recently added more “teeth” to the discharge planning process as it is outlined in the Conditions of Participation (CoP) for Discharge Planning. Discharge planning is no longer a destination but a process that starts before the patient is admitted to the hospital and continues after they are discharged. CMS has added rules that will provide a more inclusive role for patients and families. The rules also alter how we provide “choice” to our patients

The CoP is the legal and regulatory requirements that hospitals and case management professionals must follow to be compliant in their role as discharge planners. Surveyors are now reviewing your department’s compliance with the Conditions of Participation for discharge planning. It is important that all case management professionals, including both nurses and social workers, are familiar with the changes to the Conditions of Participation for Discharge. We will begin with a review of the prior rules and from there we will discuss the most recent changes from the Medicare program and how they will impact the roles of the RN case manager and the social worker. Learn how to be sure that your processes address the complexities of the new healthcare environment and that your role as a case manager or social worker is designed and staffed to meet the changes ahead and are in compliance with the federal requirements as well!

Join us in reviewing the prior rules still in effect and the new rules legislated in 2021.

This program will cover the new changes to the discharge planning standards that became effective November 2019 and published in the February 21, 2020 manual. It is anticipated CMS will publish revised interpretive guidelines and survey procedures to match the new regulations in 2021.

The regulations apply to all hospitals, and for the first time will apply to critical access hospitals.  CMS scaled back many of the proposed rules that hospitals had expressed concern about but there are still a lot of changes. CMS has section 1335 waivers during the COVID-19 pandemic and the discharge planning waivers will be discussed.

Areas Covered in the Session:-

• Conditions of Participation (CoP) for Medicare
• Current CoP for Discharge Planning
• Proposed rules for discharge planning
• New rules for 2021
• Strategies for managing the Discharge Planning CoP
• Discuss the CMS has revised the discharge planning requirements that apply to all hospitals and critical access hospitals
• Recall patients and physicians can request a discharge planning evaluation
• Discuss that information about the hospitalization must be provided to the physician or provider before the first post-hospital visit
• Describe that the patient has a right to get medical records timely including a copy of their discharge plan

Why Should you Attend?

• Understand the Conditions of Participation for discharge planning.
• Describe the components of the Social Security Act related to discharge planning.
• Review strategies for safely transitioning your patient across the continuum.
• Discuss the regulatory requirements associated with discharge planning.
• Describe the IMPACT Act and its relationship to discharge planning.
• Break down the components of patient choice.
• Apply the elements that surveyors will look for related to discharge planning

• CMS revised hospital & CAH Discharge Planning requirements
• How changes impact the discharge planning worksheet (to be amended)
• CMS Deficiency Memo and how to access deficiency/citation reports
• Discharge planning process and required planning
• Identification of patients in need of discharge planning
• Discharge planning evaluation
• RN, social worker, or qualified person to develop evaluation
• Timely evaluation
• Discussion of evaluation with patient or individual acting on their behalf
• Discharge evaluation must be in the medical record
• Documentation of the discharge process
• Discharge plan
• Physician request for discharge planning
• Implementation of the patient’s discharge plan
• Reassessment of the discharge plan
• Freedom of choice for post-acute care providers
• Document list to provide except CAHs
• Transfer or referral