Home Health & Hospice Week

Medicare rule takes a step back on many proposed discharge requirements.

Nearly four years after it was first proposed, CMS has finalized its rule on discharge planning. In addition to home health discharges, it covers those for acute and critical access hospitals.

The November 2015 Centers for Medicare & Medicaid Services rule proposed 22 items that would be required in a home health discharge or transfer summary, including medication reconciliation and “patient’s goals and treatment preferences.” CMS also solicited feedback on a deadline for the discharge summary (see Eli’s HCW, Vol. XXV, No. 39).

CMS received a deluge of comments on the home health provisions, it notes in the final rule released Sept. 25. As a result, it has rescinded or modified a number of requirements that were subject to intense criticism, but has also moved forward with less troublesome discharge planning requirements.

For example: CMS does away with its list of 22 items it was planning to require on the discharge summary. “At this time, there is no clear consensus regarding the minimum information that should be shared from one HHA to another health care provider in order to assure patient health and safety,” the final rule notes. Therefore, “establishing a specific list of information that must be shared from an HHA to another health care provider creates a risk of simultaneously overburdening HHAs with elements that are not applicable and leaving out elements that are critical to assuring a safe and effective care transition in any given situation.”

Rather, CMS will revise § 484.58(b)(1) “to require that, instead of a specified list, the HHA must send necessary medical information pertaining to the patient’s current course of illness and treatment, post-discharge goals of care, and treatment preferences to the receiving facility or health care practitioner to ensure the safe and effective transition of care,” the rule explains.

For more details on what stayed in and what went out, and what your new duties will be when the rule takes effect at the end of November, see a future issue of Eli’s Home Care Week. The final rule, which is scheduled for publication in the Sept. 30 Federal Register, is at https://s3.amazonaws.com/public-inspection.federalregister.gov/2019-20732.pdf.