MDS Alert

But the agency wants the nursing facility community to identify some of the root causes of this issue.

The extra workload associated with doing discharge assessments has become a growing concern among nursing facilities -- one that a CMS official recently addressed.

In the Jan. 27 SNF/LTC Open Door Forum, the agency's Mary Pratt noted that CMS is "in the early stages of doing some analysis of first quarter data to see what that tells us about the information that we are getting at the time of discharge. And over the next several months, we will be convening clinicians with firsthand experience, as well as other experts in the area, to help give us a balanced perspective on discharge assessment requirements," she added.

Pratt said CMS is "very much interested in finding ways that make sense and can help reduce the burden associated with these assessments."

"Of particular note," Pratt continued, CMS would like the community to look at identifying some of the root causes of these frequent resident discharges to the hospital. "Essentially these are flags" that may be opportunities for improvement -- either for the hospital or the nursing home. Pratt noted that CMS suspects that could be "the root of the problem for some of these burdensome assessments ... ."

Tips: Look at rehospitalizations where the resident could probably have been treated in the nursing facility, advises Ron Orth, NHA, CPC, RAC-CT, president of Reimbursement Solutions in Milwaukee, Wis. Preventing rehospitalization also involves using "advanced directives and educating physicians that the facility can take care of some problems in the facility."