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Discharge planning has long been a challenge for organizations, but expected revisions to Medicare's Conditions of Participation (CoP) will increase the burden on healthcare facilities, especially in case management departments, by expanding the number and type of discharge plans that must be created. Discharge Planning Guide: Tools for Compliance, Fourth Edition, is a comprehensive resource on the changes to the CoPs, which are set to revamp discharge planning not just for hospitals, but for postacute providers as well.
This book provides guidance on developing a discharge planning workflow during a time when hospitals must create discharge plans for a larger percentage of patients than ever. Essential functions of discharge planning, including patient choice, health literacy, communicating with caregivers, and delivery of notices, are presented in a clear and concise format. The book also covers the connection between discharge planning and the revenue cycle, including payment rules, billing and coding implications, and the appropriate use of several claims forms and condition codes. This book will help you:
-State the purposes of the Social Security Act, the Conditions of Participation and Conditions for Coverage (CoP/CfC), and the Interpretive Guidelines as each relates to discharge planning
-Identify sections of the CoPs for discharge planning that relate to discharge instructions
-Explain how utilization review, discharge planning, and case management interface with transition management
-Describe steps in monitoring the progress of a patient's discharge plan
-Describe the effect of the discharge planning process efficiency scores and preventable readmission
Describe when to use the Medicare Outpatient Observation Notice (MOON) according to the Notice of Observation Treatment and Implication for Care Eligibility (NOTICE) Act for observation patients
-Discuss payment rules that affect discharge planning
-Describe types of discharges and transfers from acute care hospitals, critical access hospitals, skilled nursing facilities, and home health agencies
-Outline provisions of the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014
-Discuss the revenue cycle implications discharge planning has for hospitals
