Proposed CMS rule aims to involve patients in discharge

Patient preference during the hospital discharge planning process would hold greater weight under a new proposed rule that also aims to reduce readmissions.

The Centers for Medicare & Medicaid Services proposes that healthcare providers develop discharge plans personalized to each patient's needs and preferences within 24 hours of readmission and complete the plan before discharging the patient to either home or another facility. The rule covers all inpatients as well as eligible outpatients, including those under observation status, surgical patients and emergency department patients in need of a discharge plan.

The rule would also provide detailed discharge instructions for hospital and critical access hospital patients who are sent home, develop a system for post-discharge follow-up, and create a medication reconciliation process to ensure patient safety.

The proposal further calls for hospitals and critical access hospitals to increase their attention to psychiatric and behavioral health, a major concern among emergency physicians. In such cases, the rule states, hospitals must identify what services the patients will need upon discharge, identify the community resources available to such patients and work to develop partnerships with any such organizations. The proposed rule would require organizations to involve patients in this process, coordinating with providers for post-acute mental healthcare resources.

"This rule puts the patient and their caregivers at the center of care delivery," CMS Deputy Administrator and Chief Medical Officer Patrick Conway, M.D., said in an announcement. "Patients will receive discharge instructions, based on their goals and preferences, that clearly communicate what medications and other follow-up is needed after discharge, and pertinent medical information will be communicated to providers who care for the patient after discharge. This leads to better care, smarter spending and healthier people."

The proposed rule will be published in the Federal Register on Nov. 3 and the public has 60 days to comment on it. 

To learn more:
- read the proposed rule (.pdf)
- here's the announcement