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UPDATE: Discharge Planning Requirements for Home Health Agencies

Thursday, October 17th, 2019

On September 26, 2019, the Centers for Medicare & Medicaid Services (CMS) issued a final rule regarding discharge planning requirements that will impact home health agencies, among other health care providers such as hospitals. The final rule, published in the Federal Register on September 30, 2019, updates discharge planning requirements under the various providers’ Conditions of Participation in the Medicare and Medicaid programs and strongly emphasizes patient involvement in the discharge planning process. CMS Administrator Seema Verma provided the following in a press release regarding the final rule: “Today’s rule is a huge step to providing patients with the ability to make healthcare decisions that are right for them, and gives them transparency into what used to be an opaque and confusing process. By demystifying the discharge planning process, we are improving care coordination and making the system work better for patients.”

Obligations of home health agencies under the final rule include a requirement that agencies assist its patients in choosing post-acute care (PAC) providers by sharing data regarding quality and resource use measures that are relevant to each patient’s care goals and treatment preferences. Additionally, upon discharge, home health agencies are required to transfer appropriate medical information to each patient’s selected PAC provider and other suppliers and providers involved in that patient’s follow-up and ancillary care. Home health agencies are also required by the final rule to provide such clinical information necessary to receiving facilities and/or health care practitioners upon request.

While the final rule places additional requirements on home health agencies upon discharge and transfer of patients to other providers, home health agencies must not forget the other federal and state laws that apply to disclosures of medical records and other protected health information. And home health agencies will need to ensure proper policies and procedures are in place to allow for these required disclosures, along with metrics and means by which the agencies will assist patients in selecting PAC providers based on individualized needs and goals.

Elizabeth Jepson and Allison Shelton are members of a team at Brown & Fortunato, P.C. that routinely represents home health and hospice businesses on a broad spectrum of corporate, regulatory and operational issues. You can reach Elizabeth Jepson at ejepson@bf-law.com or Allison Shelton at ashelton@bf-law.com and the Home Health and Hospice team at Brown & Fortunato at 806-345-6300.