Case Management

Mentor moment: Disclosing financial interests to patients

Case Management Weekly, November 28, 2012

The mere existence of a financial relationship between a hospital and a post-acute care provider is not by itself indicative of potential inappropriate action. 

A hospital’s referral of a patient to a post-acute care provider in which it has a financial interest would not in itself constitute fraud or abuse. Nonetheless, some discharge planners express concern that such referrals may be perceived as abuse if a substantial percentage of their patients receive them. 

However, discharge planners are responsible for qualifying agencies that will meet patient needs and for giving patients a choice of qualified agencies. If the only qualified agency has a financial relationship with the hospital, discharge planners must exercise professional judgment and feel confident in their decision when making such a referral.  

Editor’s note: This article is adapted from Discharge Planning Guide: Tools for Compliance, Third Edition published by HCPro, Inc.

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