Discharge Planning Rule Finalized After Four Years

BIRMINGHAM, Ala. (October 2, 2019)—The Centers for Medicare & Medicaid Services released a long-awaited discharge planning final rule for hospitals, critical access hospitals and home health agencies. The proposed rule was posted in November 2015, and has taken almost four years to reach the final version. It will be effective Nov. 29, 2019.

The rule, which revises the requirements for hospital discharge planning, falls under the Patients Over Paperwork initiative. Among other things, it mandates that the discharge planning process focus on the patient’s goals of care and treatment preferences. Additionally, the final rule revises the rights of hospital patients and what facilities must do to provide patients access to their medical records.

“Patients will no longer be an afterthought; they’ll be in the driver’s seat, playing an active role in their care transitions to ensure seamless coordination of care,” CMS Administrator Seema Verma said in a statement.

The National Association for Home Care & Hospice (NAHC) said in a press release that CMS addressed some of the concerns the home health industry previously raised in public comments. For example, CMS withdrew its proposal to require that a physician responsible for a plan of care be involved in the ongoing process of establishing the discharge plan because the 2017 Medicare conditions of participation for home health addressed physician involvement in the home health agency (HHA) discharge planning process. The agency indicated that it is committed to working with stakeholders to identify specific needs and concerns regarding discharge planning in the HHA care setting and to explore all options for achieving positive patient outcomes.

CMS also dropped a requirement for providers to access their state’s prescription drug monitoring program (PDMP) while discharge planning, Fierce Healthcare noted. In comments, some facilities noted they did not have access to a PDMP or their state lacked a program. CMS said that states should look into strategies such as a PDMP to help prevent drug misuse.

The final rule does still prohibit providers from steering patients toward any particular post-discharge provider and requires hospitals to disclose financial relationships with home health agencies and other provider types, according to NAHC.

The final rule posted to the Federal Register on Sept. 30. It can be read in full here.