When discharging a patient, hospitals (including long-term care hospitals, critical access hospitals, psychiatric hospitals, children’s hospitals, and cancer hospitals) are required to produce discharge plans for any patients that are at risk for adverse events (chronic illness, post orthopedic surgery, wounds, etc). A key component of the new Revisions to Discharge Planning Requirements (CMS-3317-F) is that hospitals are now required to equip patients with information on performance and quality metrics of HHAs to allow the patient to make an informed decision on their post-acute care. Hospitals are also expected to give patients the option to return to the same HHA from which they received services prior to their hospitalization.

CMS’s goal for the rule is to reduce readmissions and adverse events by complementing and aligning care efforts across the continuum, while giving patients visibility into the care plan processes and putting them at the forefront of their care decisions. It’s evident that the push for patient-centered care is strong, and HHAs should see this as a major incentive to enhance their overall performance.

Improving your quality measures

Patients are reviewing your agency’s quality measures and comparing them to competitors now more than ever. Worried that your measures aren’t where they should be? These steps can help your agency stand out and become a top-choice for new patients.

Pull and monitor scores

First things first – if you don’t know your agency’s scores, pull them from Medicare’s Home Health Compare website. Confirm the data is accurate and up to date, then ensure your scores are being consistently monitored or that your current monitoring methods are enhanced. Take special note of your STAR ratings and other quality scores that are publicly reported, as these are the scores that will be shared with patients.

Make an action plan

If your scores aren’t where you want them to be, it’s not too late to turn them around. Collaborate with agency leaders and design corrective action plans for any identifiable issues to streamline processes and make your agency more operationally efficient. If you find yourself struggle to pinpoint your problem areas, consider using a third party to help target the root cause of your challenges.

Communicate with hospitals

The last thing you want is hospitals telling a potential patient inaccurate information about your agency. Reach out to all the hospitals and applicable facilities that will be sharing your agency’s information to ensure the accuracy of the data and that it is the most up to date version.

Read and re-read the policy

The best way to combat any challenges that may arise from the new discharge plan is to make sure you thoroughly understand it, as well as other discharge policies and how they apply to your organizations processes. Review the HHA discharge policies and practices to assure “at risk” patients are informed of the status of their care goals and treatment during their home health services.

Educate your clinicians

Provide education and written instructions to your clinicians on how to communicate with patients at their time of discharge. Make sure your clinicians inform patients of all the care services offered by your agency so they know they can return to your agency for any future services they may need.

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