Future Focus December 5, 2018: Discharge Planning New Rules Delayed

Lisa Remington

We have been keeping a close eye on discharge planning.  In this week’s FutureFocus, we provide more details about CMS delaying new discharge planning rules. This is important for your organization to know because it provides insight into the future and the considerations for discharge planning, the IMPACT act, and the new roles for hospitals and post-acute providers.

Lisa Remington, President, Remington Health Strategy Group

By: Elizabeth Hogue, Attorney

On November 3, 2015, the Centers for Medicare & Medicaid Services (CMS) published proposed regulations governing discharge planning by hospitals. If finalized as proposed, these regulations will require hospitals to devote considerably more time and resources to discharge planning activities.

Generally speaking, proposed rules must be finalized within three years of their publication. CMS announced on November 2, 2018, however, that finalization of the new rule on discharge planning has been delayed because of the "complexity of the rule and scope of public comments."The proposed rule implements provisions of the Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act). As proposed, the new rules on discharge planning will apply to all types of hospitals, including acute care, long term acute care hospitals (LTACHs), inpatient rehabilitation facilities (IRFs), and home health agencies. Proposed changes in Conditions of Participation (CoPs) for hospitals generally require:

  1. Development and implementation of an effective discharge planning process that focuses on patients' goals and preferences and prepares  patients and their caregiver(s)/support person(s) to be active partners in post-discharge care
  2. Planning for care that is consistent with patients' goals for care and treatment preferences
  3. Effective transition of patients from hospitals to post-discharge care
  4. Reduction of factors leading to preventable hospital readmissions

Specifically, policies and procedures of hospitals governing discharge planning activities must be:

  • Developed with input from hospitals' medical staff, nursing leadership and other relevant departments
  • Reviewed and approved by governing bodies of hospitals
  • Specified in writing

The proposed regulations require the discharge planning process to be applied to:

  • All inpatients
  • Outpatients receiving observation services
  • Outpatients undergoing surgery or other same day procedures for which anesthesia or moderate sedation is used
  • Emergency department patients identified in accordance with hospitals' discharge planning policies and procedures by emergency department practitioners responsible for the care of patients who need a discharge plan
  • Any other category of outpatients as recommended by the medical staff and specified in hospitals' discharge planning policies and procedures approved by hospitals' governing bodies

If finalized, these changes in discharge planning activities are significant in terms of the resources and skills that will be needed to meet new requirements! Stay tuned for publication of the final rule.

©2018 Elizabeth E. Hogue, Esq.  All rights reserved. No portion of this material may be reproduced in any form without the advance written permission of the author.

Added resources on discharge planning:https://remingtonreport.com/insights/futurefocus/171-futurefocus-june-27-2017-discharge-planning-cms-guidance-needed.html