Description

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Discharge planning has long been a challenge for organizations, but expected revisions to Medicare's Conditions of Participation(CoP) will increase the burden on healthcare facilities, especially in case management departments, by expanding the number and type of discharge plans that must be created. Discharge Planning Guide: Tools for Compliance, Fourth Edition, is a comprehensive resource on the changes to the CoPs, which are set to revamp discharge planning not just for hospitals, but for postacute providers as well.

This book provides guidance on developing a discharge planning workflow during a time when hospitals must create discharge plans for a larger percentage of patients than ever. Essential functions of discharge planning, including patient choice, health literacy, communicating with caregivers, and delivery of notices, are presented in a clear and concise format. The book also covers the connection between discharge planning and the revenue cycle, including payment rules, billing and coding implications, and the appropriate use of several claims forms and condition codes.

This book will help you:
State the purposes of the Social Security Act, the Conditions of Participation and Conditions for Coverage (CoP/CfC), and the Interpretive Guidelines as each relates to discharge planning
Identify sections of the CoPs for discharge planning that relate to discharge instructions
Explain how utilization review, discharge planning, and case management interface with transition management
Describe steps in monitoring the progress of a patient's discharge plan
Describe the effect of the discharge planning process efficiency scores and preventable readmission
Describe when to use the Medicare Outpatient Observation Notice (MOON) according to the Notice of Observation Treatment and Implication for Care Eligibility (NOTICE) Act for observation patients
Discuss payment rules that affect discharge planning
Describe types of discharges and transfers from acute care hospitals, critical access hospitals, skilled nursing facilities, and home health agencies
Outline provisions of the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014
Discuss the revenue cycle implications discharge planning has for hospitals

About the Author

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Jackie Birmingham, RN, BSN, MS, CMAC, is the vice president emerita of clinical leadership and regulatory monitoring for Curaspan Health Group. In her role, Birmingham works with industry leaders to monitor federal laws that impact the process and practice of discharge planning, transition management, and case management. She has more than 30 years of experience in transition of care healthcare settings with other organizations, including roles as director of discharge planning, director of quality improvement, and nursing school faculty. Birmingham is the author of several books and journal articles about case management, discharge planning, and transition management. A frequent speaker, she has presented programs throughout the United States and in Great Britain and Spain. She also serves as an educator for providers and payers, focusing on discharge planning, transition of care management, and continuity of care. A member of the American Case Management Association (ACMA), she served on the committee to develop standards of practice for hospital-based case managers. She has been honored by The Case Management Society of America as one of its Distinguished Case Managers of the Year. As a member of the Editorial Board of Professional Case Management and a holder of Case Management Administrator Certification, Birmingham is constantly monitoring the professional practice of care transition at all levels. Disclosure statement The planners, presenters/authors, and contributors of this CE activity have disclosed no relevant financial relationships with any commercial companies pertaining to this activity.