Under the proposed rule, hospitals and critical access hospitals would be required to develop a discharge plan within 24 hours of admission or registration and complete a discharge plan before the patient is discharged home or transferred to another facility.

The IMPACT Act requires hospitals, critical access hospitals, term care hospitals and inpatient rehabilitation facilities, and home health agencies to use data on both quality and resource use measures to assist patients during the discharge planning process, while taking into account the patient’s goals of care and treatment preferences.

This would apply to all inpatients and certain types of outpatients, including patients receiving observation services, patients who are undergoing surgery or other same-day procedures where anesthesia or moderate sedation is used, and emergency department patients who have been identified by a practitioner as needing a discharge plan.

“The IMPACT Act requires hospitals, critical access hospitals, term care hospitals and inpatient rehabilitation facilities, and home health agencies to use data on both quality and resource use measures to assist patients during the discharge planning process.”

In addition, hospitals, critical access hospitals, and home health agencies would have to:

  • Provide discharge instructions to patients who are discharged home (proposed for hospitals and critical access hospitals only);
  • Have a medication reconciliation process with the goal of improving patient safety by enhancing medication management (proposed for hospitals and critical access hospitals only);
  • For patients who are transferred to another facility, send specific medical information to the receiving facility; and
  • Establish a post-discharge follow-up process (proposed for hospitals and critical access hospitals only.


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