Case Management

Patients deserve a choice in the discharge plan

Case Management Monthly, June 1, 2010

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Hospitals do have options when it comes to documenting that the patient was given a choice of postacute facilities, including:

  • A form that a patient or significant other must sign.
  • A staff-written narrative note in the medical record. 
  • Discharge technology that automatically generates a choice letter given to patients and their families. The letter is a function of the software that allows its inclusion in patients’ medical records.

The Conditions of Participation for Discharge Planning and the Interpretive Guidelines for Hospitals (p. 293) include references to the rules.

“Medicare doesn’t tell hospitals how to document choice—although some wish that it would—because of the varied nature of hospitals,” writes Jackie Birmingham, RN, MS, vice president of Curaspan Health Group in Newton, MA.

Hospitals can either give patients a form to sign or ask for verbal communication. If the hospital provides patients with a postdischarge choice verbally, you should document that conversation in the patients’ records, says Birmingham.

Medicare allows hospitals to develop policies based upon what will best meet the needs of their patient population.

This is an excerpt from a member only article. To read the article in its entirety, please login or subscribe to Case Management Monthly.

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