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 CMS Issues Final Rule on Discharge Requirements

The Centers for Medicare & Medicaid Services (CMS) on Sept. 26 issued a final rule (Revisions to Discharge Planning Requirements, CMS-3317-F) that details discharge requirements for hospitals, including information-sharing requirements for downstream providers such as post-acute care (PAC) providers.  

These new provisions could be of assistance with securing needed clinical information for the Patient-Driven Payment Model, according to skilled nursing profession experts. 

CMS said the final 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.”

The measures include those 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, CMS said.

“The rule also advances CMS’ historic interoperability efforts by requiring the seamless exchange of patient information between health care settings and ensuring that a patient’s health care information follows them after discharge from a hospital or PAC provider,” the agency said.

CMS Administrator Seema Verma added that the rule is a huge step toward providing patients with the ability to make health care decisions that are right for them, and gives them transparency into what used “to be an opaque and confusing process.”

“By demystifying the discharge planning process, we are improving care coordination and making the system work better for patients,” she said.

Details of the final rule encompass discharge planning requirements that hospitals (including long-term care hospitals, critical access hospitals, psychiatric hospitals, children’s hospitals, and cancer hospitals), inpatient rehabilitation facilities, and home health agencies must meet to participate in Medicare and Medicaid programs.

“It requires the discharge planning process to focus on a patient’s goals and treatment preferences. Additionally, hospitals are mandated to ensure each patient’s right to access their medical records in an electronic format,” CMS said.

The rule also implements requirements from the Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act) that covers how facilities will account for and document a patient’s goals of care and treatment preferences.

Additionally, if a patient is being discharged to a PAC provider, the rule requires the facility’s care team to assist patients, their families, or the patient’s representative in selecting a PAC provider by sharing key performance data.

“This data must be relevant and applicable to the patient’s goals of care and treatment preferences. CMS expects providers to document all efforts regarding these requirements in the patient’s medical record,” the agency said. 

The American Health Care Association said it is reviewing the final rule.

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