PointRight Helps Hospitals Comply
By Janine Savage, RN, RAC-CT, CHC
September 26, 2019, The Centers for Medicare & Medicaid Services (CMS) issued a Final Rule addressing acute care to post-acute care (PAC) discharge planning. There are many complex and detailed requirements and prohibitions in this Final Rule that aim to improve patient engagement and decrease hospital readmissions. It calls out several laws and regulations that have caused compliance concerns about discharge planning for many years, and it is the most comprehensive regulatory rulemaking on this topic to date.
What does the Final Rule Address?
The Final Rule addresses care transitions, coordination of care, interoperability, and patient choice. It not only allows hospitals to share information about quality related to PAC providers, but it requires them to do so – while prohibiting hospitals from developing “preferred provider” lists.
The rule also addresses interoperability, which has been an increasing focus of CMS. Hospitals must ensure and support patients’ rights to access their medical records in the format requested by the patient, if they are readily producible in that format (including electronic when medical records are maintained electronically).
This rule implements requirements from the Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act). If a patient is being discharged to a PAC provider, it requires the hospital’s care team to assist patients (or their family or representative) in selecting a PAC provider by sharing key performance data about that provider that is relevant and applicable to the patient’s goals of care and treatment preferences. It specifically refers to the quality measures and resource use measures that are prescribed by the IMPACT Act.
The Discharge Planning Final Rule’s effective date is 11/29/2019. For more information, access the CMS Fact Sheet.
How PointRight Helps
PointRight solutions help hospitals meet the requirements of the Final Rule and achieve a comprehensive and compliant discharge planning process by assisting patients in selecting a PAC provider that best meets their needs and preferences. The features of PointRight solutions go far beyond that of Nursing Home Compare and are specifically designed for this purpose.
PointRight’s ScoreCard supports discharge planning to SNFs by providing patients with a customized list of SNF providers in the geographic area they request, with key performance and quality outcomes data relevant and applicable to their goals of care and treatment preferences.
PointRight’s Home Health ScoreCard supports discharge planning to home health with quality and resource use information about home health agencies that service the patient’s home county. (Contact us to learn more.)
Janine Savage, RN, RAC-CT, CHC
Vice President, Product Management, PointRight
Janine is Certified in Healthcare Compliance (CHC) and leverages her knowledge of relevant regulations and expertise in compliance processes to assist organizations in promoting organizational integrity through the operation of effective compliance programs.