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CMS Finalizes Discharge Planning Rule

The Centers for Medicare & Medicaid Services (CMS) finalized a rule on discharge planning for hospitals, including long-term care hospitals and inpatient rehabilitation facilities, critical access hospitals, and home health agencies that participate in Medicare and Medicaid.

The agency first proposed the discharge planning rule in November 2015 and in October 2018 announced a one-year extension to publish the final rule.

CMS also finalized certain provisions of a June 2016 proposed rule on promoting innovation, flexibility, and improvement in patient care.

Discharge Planning

Under the discharge planning rule, hospitals must create discharge plans for all inpatients and specific categories of outpatients. The plans must consider the patient’s goals and preferences, as well as certain quality and resource use information required by the Improving Medicare Post-Acute Care Transformation Act of 2014. These revisions give patients and their families access to information that encourages active participation in post–acute care planning and may reduce patients’ chances of being rehospitalized.

CMS also finalized requirements that hospitals use and share data to assist patients, their families, or their caregivers/support persons in selecting a post-acute care provider.

In response to stakeholder comments, including those from America’s Essential Hospitals, CMS did not finalize several burdensome requirements included in the proposed rule.

CMS did not finalize prescriptive rules related to hospitals’ discharge planning process, including approval by the hospital’s governing body and mandatory review of the policies every two years. CMS also provided additional flexibility by scaling back a proposal to broaden the scope of patients covered in the discharge planning.

Hospital Innovation

CMS also finalized provisions from the 2016 hospital innovation proposed rule regarding patient access to medical records. Each patient has a right to access their current and previous medical records upon oral or written request, in the form and format requested by the individual, if records are readily producible in such form and format. This includes an electronic form or format when such medical records are maintained electronically.

The rule takes effect 60 days after the final rule is published in the Federal Register.

America’s Essential Hospitals is analyzing the final rule and will release a detailed Action Update in the coming days.

Contact Senior Director of Policy Erin O’Malley at eomalley@essentialhospitals.org or 202.585.0127 with questions.

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About the Author

Rachel Schwartz is a policy associate at America's Essential Hospitals.

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