Case Management

Tip: Understand Medicare options for late-day discharges

Case Management Weekly, January 11, 2012

Discharge planners must consider late-day discharges. Many hospitals target a specific discharge time, such as 11 a.m. This target is possible if the patient is medically ready for discharge, has a plan in place, and has undergone the required steps such as patient education and delivery of the Important Message from Medicare.

Chapter 3 of the Medicare Benefit Policy Manual addresses late discharges as follows:

When a patient chooses to continue to occupy hospital or SNF accommodations beyond the checkout time for personal reasons, the hospital or SNF may charge the beneficiary for the continued stay. Such a stay beyond the checkout time, for the comfort or convenience of the patient, is not covered under the program, and the hospital’s or SNF’s agreement to participate in the program does not preclude charging the patient. However, the hospital must provide the beneficiary with an Advanced Beneficiary Notice (ABN) before the noncovered services are provided.

This means there is an option for late discharges, which should be used to ensure that efforts to manage patient flow, affected by a patient who doesn’t leave, are discussed with that patient.

This was adapted from Discharge Planning Guide: Tools for Compliance, Third Edition, published by HCPro, Inc. For more information about this book or to order your copy, visit the HCMarketplace.

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