Q&A: Which hospital patients must be screened an assessed for a discharge plan?

Q: Which hospital patients must be screened an assessed for a discharge plan?

A: Currently, CMS requires a discharge planning process for all inpatients. The best practice suggestion is to include a discharge planning process for some outpatients, such as observation patients, patients discharged from surgery for same-day procedures, and certain ED patients who are determined to need discharge planning. The discharge planning process includes:

• Screening all inpatients at risk of adverse health consequences after discharge if they have no discharge planning services
• Evaluating postacute care needs of patients identified above, those who self-identify, or those identified by physicians as needing a discharge plan
• Developing a discharge plan if needed or if a physician requests one
• Implementing the discharge plan prior to discharge

For more information about screening and assessments, see the Case Management Patient Communication Toolkit.

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