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Understanding The New CMS Discharge Rules

December 23, 2019

The Centers for Medicare and Medicaid Services (CMS) published a final rule on September 30, 2019, that requires hospitals to make substantial changes in discharge planning.  The final rule is effective sixty days from publication, so it becomes effective on November 29, 2019.


In the meanwhile, many hospital discharge planners/case managers and post-acute providers who receive referrals from hospitals are especially interested in any changes regarding patients’ right to freedom of choice.


First, CMS clarifies that CoPs for hospitals apply to acute care hospitals, long-term care hospitals (LTCHs), independent rehab facilities (IRFs), short-term acute care hospitals, rehabilitation hospitals, psychiatric hospitals, children’s hospitals and cancer hospitals.


CMS then clarifies that discharge planners/case managers cannot make decisions on post-acute services on behalf of patients and their caregivers.  Hospitals must focus instead on person-centered care to ensure the active participation of patients and their caregivers in decisions about post-acute care.


CMS also states that the IMPACT Act requires hospitals to take into account quality, resource use and other measures in the discharge planning process.  Specifically, CMS says that hospitals’ discharge planners/case managers must use IRF Compare, Home Health Compare, Nursing Home Compare and Long-Term Care Compare to assist patients and their caregivers to make decisions about post-acute providers.