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The final rules for Discharge Planning arrived after a three-year wait! The Centers for Medicare and Medicaid Services (CMS) have recently added more “teeth” to the discharge planning process as it is outlined in the Conditions of Participation for Discharge Planning. The CoP are the legal and regulatory requirements that hospitals and case management professionals must follow in order to be compliant in their role as discharge planners. Surveyors are now reviewing your department’s compliance with the Conditions of Participation for discharge planning. It is important that all case management professionals, including both nurses and social workers, are familiar with the changes to the Conditions of Participation for Discharge.

We will begin with a review of the prior rules and from there we will discuss the most recent changes from the Medicare program and how they will impact the roles of the RN case manager and the social worker. Learn how to be sure that your processes address the complexities of the new healthcare environment and that your role as a case manager or social worker is designed and staffed to meet the changes ahead and are in compliance with the federal requirements as well!

Discharge planning is no longer a destination but a process that starts before the patient is admitted to the hospital and continues after they are discharged. The rules alter the ways in which we provide “choice” to our patients.  In this program, we will start by reviewing the current rules for discharge planning. Are you compliant with these rules? Family caregivers and physicians are expected to be much more involved than they have in the past. Be sure you know the old rules and the new rules so that your practice will be current and legal! We will review strategies for integrating these requirements into your daily practice.

Learning Objectives:

• Discuss the Conditions of Participation and their relevance on case management.
• Review the current rules for discharge planning under the CMS Conditions of Participation
• Identify strategies for being compliant with the new rules.
• Discuss the new roles for patients and families in discharge planning.
• Review the enhanced role for the physician in discharge planning.
• Understand the documentation requirements under the new discharge planning rules.

Areas Covered in the Session

• Conditions of Participation (CoP) for Medicare
• Current CoP for Discharge Planning
• New rules for 2023
• Strategies for managing the Discharge Planning CoP
• The role of the physician in discharge planning
• How to maintain compliance
• Integrating patients and families into the discharge planning process
• Discharge Planning: The Past
• Barriers to Successful Discharge Planning and Care Transitions
• Effective Discharge Planning and Care Transitions
• Barriers to Successful Care Discharge Planning and Transitions: Readmissions
• From Discharge to Transitions
• American Case Management Association Transitions of Care Standards
• Expectations of Effective Transitions of Care
• Discharge Planning Rules and Regulations
• Center For Medicare and Medicaid Services (CMS) Conditions of Participation (CoPs) For Hospitals: 42 C.F.R. Part 482
• CMS Conditions of Participation: Discharge Planning 482.43
• Challenges of The CoPs Final Rule For Discharge Planning
• Transformation (Impact) Act (2016)
• Notice Act (Notice of Observation Treatment and Implication For Care Eligibility Act)
• Preadmission Screening and Residential Review (PASRR) Regulation
• Notification of Discharge Appeal Rights Regulation
• Post Hospital Extended Care Services 3-day Stay Rule
• A Payer’s Compliance Expectations
• Acute Care Discharge Planning
• Acute Care Discharge Planning Process – 9 Steps
• Discharge Time-Out
• Bridging Interventions For SNF Readmissions To Hospital
• Coordinating Care With Post-acute Care
• Post-Discharge Follow-U
• Home Care Is Critical
• Identification of Patients For Referral To Home Care Services – Guidelines For Home Care Assessment
• Sample Case Management Discharge Planning Gap Analysis

Suggested Attendees

• RN Case Managers
• Social Workers
• Vice Presidents of Operations
• Director of Case Management
• Case Managers
• Directors and Vice Presidents of Nursing
• Directors of Patient Flow
• Director of Revenue Cycle
• Chief Financial Officers
• Chief Operations Officers
• Chief Medical Officer
• Hospitalists
• Director of Quality Management
• Nursing Home Directors
• Director of Home Care
• Director of Finance
• Case Managers
• Social Workers
• Vice President of Case Management
• Hospitalists
• Physician Advisors
• Directors of Social Work

About the Presenter