September 30, 2019

On September 26, 2019, the Centers for Medicare and Medicaid Services (“CMS”) published finalized revisions to 42 CFR Parts 482, 484, and 485 regarding patient discharge planning.  The rule was first proposed on November 3, 2015 and was granted an unusual extension to the typical three-year threshold due to the complexity of the proposed rule and extent of public comments.  The final rule changes discharge planning requirements for acute-care hospitals, long-term care hospitals, inpatient rehabilitation facilities, inpatient psychiatric facilities, children’s hospitals, cancer hospitals, critical access hospitals (“CAHs”), and home health agencies (“HHAs”) for patients transitioning from acute to post-acute care (“PAC”) settings.  

Hospitals must provide patients access to information on PAC providers’ performance on quality and resource-use measures, including 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.  Additional requirements draw from the Improving Medicare Post-Acute Transformation Act of 2014 (“IMPACT Act”) where facilities must document a patient’s goals and treatment preferences. The rule also requires the seamless exchange of a patient’s medical information between healthcare settings and ensures each patient’s right to access his or her medical records in a readily producible format.  These efforts are intended to improve interoperability of patient medical information while ensuring coordination of continued care.

While many hospitals and facilities are already fulfilling most of the discharge planning requirements, these are new for CAHs and HHAs who were not previously held to any requirements related to discharge planning.  CMS estimates that hospitals and HHAs as a whole will spend approximately $215 million per year overall to comply with the discharge planning changes, in addition to an estimated $46.5 million in one-time costs.

If you have any questions or need assistance with implementing changes related to the CMS final rule on discharge planning, please contact Hancock Daniel’s Compliance, Licensure, Certification and Enrollment Services, and Accreditation and Certification Surveys teams.

The information contained in this advisory is for general educational purposes only. It is presented with the understanding that neither the author nor Hancock, Daniel & Johnson, P.C., is offering any legal or other professional services. Since the law in many areas is complex and can change rapidly, this information may not apply to a given factual situation and can become outdated. Individuals desiring legal advice should consult legal counsel for up-to-date and fact-specific advice. Under no circumstances will the author or Hancock, Daniel  & Johnson, P.C. be liable for any direct, indirect, or consequential damages resulting from the use of this material.

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