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Discharge Planning: Why Your Hospital Could Forfeit Millions to the Feds

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Your hospital could forfeit millions of dollars for failure to comply with policy changes about the Medicare Hospital Readmission Reduction Program (HRRP) that penalizes hospitals for excessive readmissions.

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Now is the time and this RACmonitor webcast is the place to refocus your efforts on your hospital's patient discharge planning process. To begin, you should ask yourself these pivotal questions:

  • Does my organization have fully compliant interdisciplinary discharge planning processes, including special protocols for discharging of homeless patients?
  • Have you prepared discharge plans for patients undergoing outpatient surgery?
  • How prepared are my patients for transition to outpatient care?
  • Do your medication reconciliations provide patients the proper information?

If you can't answer these questions affirmatively, you are encouraged to register to attend this timely and important webcast led by two uniquely qualified healthcare leaders: Ronald Hirsch, MD, FACP, CHCQM and Marvin D. Mitchell, RN, BSN, MBA.

The Centers for Medicare & Medicaid Services (CMS) has long required a number of discharge planning policies and procedures that must be followed for all patients. Keep in mind that proper discharge planning can prevent unnecessary readmissions and monetary fines.

Planning for patient discharge has been a core competency in hospitals for many years. Recent changes to the healthcare environment have increased its importance. The CMS Hospital Readmission Reduction Program (HRRP) penalizes hospitals for excessive readmissions— readmissions that are often the result of a poor discharge process and faulty medical decision-making. Adding to the problem of ensuring proper discharge planning are patient satisfaction surveys that ask about the patient's preparedness for discharge. Bundled payment programs also count on comprehensive discharge planning to reduce returns to the hospital. Readmission focus should shift from a financial decision to something more serious: Medicare and Medicaid participation.

Proper discharge planning is not a new subject. The Medicare Conditions of Participation (CoPs) have addressed discharge planning for many years but in 2013 CMS added "blue box" advisories—surveyor worksheets for assessing compliance with the CMS hospital CoPs for discharge planning along with suggestions for ways hospitals could improve the discharge process. In 2015 CMS proposed sweeping changes to the CoPs. Three years passed, and that proposal was set to be retired when CMS extended their review period for a year, opening up the likelihood that many of the proposed changes will be adopted.

Always on the cutting edge, and in response to some high-profile missteps by hospitals, California adopted specific discharge planning requirements for homeless patients. The first of these requirements is now in effect (as of January 1, 2019). The remainder will go into effect July 1, 2019. As more attention is paid to the requirements of social determinants of health, expect that these will soon be required in all states. And, even if not required, these policies will provide a blueprint for hospitals to help their homeless patients.

Why This is Relevant:

The proposed CoPs changes are now closer to reality and likely to be adopted. This will require significant changes to workflow in hospitals. The increasing emphasis on readmissions and bundled payments makes optimal discharges an important goal for every facility.

Learning Objectives:

During this unique webcast led by Ronald Hirsch, MD, FACP, CHCQM; and Marvin Mitchell, RN, BSN, MBA, you will…

  • Learn about current requirements for compliant discharge planning;
  • Understand the proposed changes to discharge planning CoPs;
  • Learn the best practice methods to ensure compliance with new CoPs requirements;
  • Gain an understanding of the California homeless discharge planning laws; and
  • Learn how elements comply with California laws.

Who Should Attend:

Case managers, social workers, chief nursing officers, chief medical officers and compliance and quality personnel.