Description:-

This program will discuss the final surveyor worksheet for assessing compliance with the CMS Hospital Conditions of Participation (CoPs) for discharge planning. This worksheet is used by State and Federal surveyors in all survey activity in hospitals assessing compliance with the discharge planning standards. The worksheet will be revised in 2017 to reflect the proposed discharged planning guidelines when finalized. This webinar will discuss what has changed based on the IMPACT Act and the proposed discharge planning standards which are significant.

The discharge planning worksheet states that medical record information, such as a discharge summary, should be dictated and in the hands of the primary care physician or another physician before the first post-hospital visit. The proposed changes will require that this is done within 48 hours of discharge. Is your hospital familiar with the interpretive guidelines and the worksheet information? Come learn what other important things CMS has in their final worksheet which addresses preventing hospital readmissions.

This program will also cover the CMS hospital discharge planning standards. The Center for Medicare and Medicaid Services (CMS) rewrote all of the interpretive guidelines on the hospital discharge planning standards on July 19, 2013, to match what is in the current worksheet. The memo was 39 pages long and the prior 24 standards were consolidated into 13. The CMS proposed changes to discharge planning include 5 things to include in the admission assessment, 5 data things to measure, 5 things that must be in the discharge instruction, changes to the discharge planning evaluation, and 21 things in the transfer form. In addition, the hospital will need to amend the discharge planning evaluation form which must be done on all inpatients. Medication reconciliation has been added along with providing written information on side effects of medications. The discharge summary and discharge instruction sheet will need to be in the hands of the PCP within 48 hours.

Come join this important webinar to learn about what your hospital has to do to be in compliance with the discharge planning standards. CMS has published showing the number of deficiencies that hospitals have already received in the discharge planning standards and this data will be provided.

CMS has included something new in the memo known as “blue boxes.” The blue boxes contain advisory practices which are a recommendation to improve patient outcomes. Blue box recommendations are not required for hospital compliance. A crosswalk will be included between the prior tags and the revised tags.

Discharge planning is not only important to ensure compliance with the CMS standards but also for reimbursement. Optimal discharge planning can help prevent unnecessary readmissions. Hospitals that have a higher readmission rate can be financially penalized. In fact, 2,597 hospitals forfeited $528 million in 2017.

Every hospital that accepts Medicare and Medicaid must be in compliance with the CMS discharge planning guidelines. These standards must be followed for all patients and not just Medicare or Medicaid. CMS requires a number of discharge planning policies and procedures so come learn which ones are required and why.

 Agenda of the session:

• CMS issues Discharge Planning memo issued
• Transmittal issued and into final manual
• IMPACT Act and the CMS Proposed Changes to discharge planning
• How this will impact the discharge planning worksheet
• CMS Deficiency Memo shows this is a problematic area
• Introduction
• Blue box or advisory boxes
• CMS crosswalk to old tags
• Discharge planning
  • Discharge planning process
  • Discharge planning P&P required
  • Transition planning or community care transitions
  • Reducing number of hospital readmission
  • Causes of preventable readmissions
  • Inpatients verses outpatients
  • Four stage discharge planning process
  • Discharge planning evaluation
• Identification of patients in need of discharge  planning
  • Discharge plan for every patient; optional or mandatory?
  • Important four factors in discharge planning
  • P&P must include criteria and screening process
  • Identification at early stage for discharge planning
  • 48-hour rule
  • Patient transfers
• Discharge planning evaluation
  • Evaluation of likelihood of needing post-hospital services
  • Self-care assessment
  • Screening versus evaluation
  • Evaluation requirements
  • Returns to the LTC facility
  • Developing collaborative partnerships with post-hospital providers
  • Ability to pay out of pocket expenses must be discussed
  • Right to participate in the development of their plan of care
  • Interviews of patients to show awareness of right to request discharge planning
• 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
• Discharge plan
• Physician request for discharge planning
• Implementation of the patient’s discharge plan
• Reassessment of the discharge plan
• Freedom of choice for LTC or home health agencies
• Transfer or referral
• crosswalk

Discharge Planning Worksheet

• Completion of intake form; name, CCN number, deemed status
• Complete form in advance of survey
• Discharge planning policies for all inpatients
• Discharge planning for certain outpatients
• Preparation of discharge plan for all inpatients
• Discharge planning policy requirements
• Process to notify patients and doctors can request an evaluation
• Interview of patients and questions asked
• Interview questions for physicians
• Reassessment of the discharge plan
• Feedback process from post-acute hospital providers (LTC, home health)
• Criteria and screening process for discharge planning evaluations
• Qualified social workers and discharge planners
• Self-care evaluation
• Assessment of ADL
• Medical equipment for home
• Patient representative involvement
• Medication reconciliation
• Written and legible discharge instructions
• Referrals and transfers
• Readmissions within 30 days
• Any tests pending when patient discharged and process
• Changes for 2017

Objectives of the session:

• Discuss the CMS has published a worksheet on discharge planning
• Discuss that the IMPACT Act and the CMS proposed changes to discharge planning will result in many changes for hospitals
• Recall that CMS has discharge planning standards that every hospital must follow
• Discuss that one in every five Medicare patients is readmitted within 30 days of discharge and many suffer adverse events

Who Should Attend?

Discharge planners, transitional care nurses, social workers, chief nursing officer, compliance officer, chief operation officer, chief medical officers, physicians, all nurses with direct patient care, risk managers, social workers, regulatory officer, physician advisor, UR nurses, compliance officer, Joint Commission coordinator, nurse educators, chief operating officer, chief executive officer, staff nurses, physicians, nurse managers, PI director, health information director, billing office director, patient safety officer, and anyone else involved with the discharge planning. Any person serving on a hospital committee to redesign the discharge process to prevent unnecessary readmissions should also attend.