A key manager at a home health agency recently related an instance that seems like a clear failure to comply with applicable standards for discharge planning from hospitals. The manager said that the Agency received a referral from a hospital and subsequently admitted the patient. Two days after the patient was admitted to the Agency, the hospital notified the Agency that the patient was positive for COVID-19!
So, the staff members who visited this patient were then quarantined. The Agency notified the state health department whose staff contacted all of the patients seen by staff members who also visited the patient who tested positive for COVID-19. All of the patients were quarantined.
Apart from the significant facts that the Agency now has fewer staff members to care for patients, patients are inconvenienced, and patients and caregivers may contract the virus with possibly dire results, this conduct is a clear violation of applicable standards of care for discharge planning for hospitals.
The Centers for Medicare and Medicaid Services (CMS) recently issued new Conditions of Participation (COPs) for hospitals. These new rules were effective on November 29, 2019. New COPs for hospitals are applicable to acute care hospitals, long-term care hospitals (LTCHs), inpatient rehabilitation facilities (IRFs), inpatient psychiatric facilities, children’s hospitals, cancer hospitals, and critical access hospitals (CAHs). COPs for hospitals now generally require the discharge planning process to include:
- Transfer and referrals of patients along with necessary medical information at the time of discharge to appropriate post-acute (PAC) services providers and suppliers, facilities, and agencies and to other patient service providers and practitioners responsible for patients’ follow-up or ancillary care
- Provision of necessary medical information to receiving facilities or appropriate PAC providers and practitioners responsible for patients’ follow up care after patients are discharged from hospitals or transferred to other PACs or, for HHAs, other HHAs
A diagnosis of COVID-19 surely qualifies as “necessary medical information” that must be provided by discharge planners/case managers to PAC providers when patients are discharged from hospitals. Anecdotally, PAC providers; including home health agencies, hospices, private duty agencies HME companies, skilled nursing facilities (SNFs) and assisted living facilities (ALFs); have complained for many years that hospital discharge planners/case managers do not provide essential information when patients are referred to them. This instance certainly seems to be an egregious example of these complaints!
Hospital discharge planners/case managers may be disciplined for their failure to meet applicable standards. Most hospital discharge planners/case managers are licensed nurses or social workers. They are subject to discipline by state licensure boards. Provided with the facts described above, it seems highly likely that state licensure boards will discipline hospital discharge planners/case managers for these types of lapses.
Hospital discharge planners/case managers must now be meticulous about providing essential information to PAC providers when patients are discharged. The stakes are high for patients, caregivers and for hospital discharge planners/case managers themselves!
©2020 Elizabeth E. Hogue, Esq. All rights reserved.