Best Practices in Discharge Planning Including a Review of the CMS Conditions of Participation

Date : April 28, 2022
Time: 01:00 PM ET
Duration: 60 Minutes
Speaker : Dr. Toni G. Cesta

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Description

The final rules for Discharge Planning arrived after a three year wait! The Centers for Medicare and Medicaid Services (CMS) have recently added more “teeth” to the discharge planning process as it is outlined in the Conditions of Participation for Discharge Planning. The CoP are the legal and regulatory requirements that hospitals and case management professionals must follow in order to be compliant in their role as discharge planners. Surveyors are now reviewing your department’s compliance with the Conditions of Participation for discharge planning. It is important that all case management professionals, including both nurses and social workers, are familiar with the changes to the Conditions of Participation for Discharge.

We will begin with a review of the prior rules and from there we will discuss the most recent changes from the Medicare program and how they will impact the roles of the RN case manager and the social worker. Learn how to be sure that your processes address the complexities of the new healthcare environment and that your role as a case manager or social worker is designed and staffed to meet the changes ahead and are in compliance with the federal requirements as well!

Discharge planning is no longer a destination but a process that starts before the patient is admitted to the hospital and continues after they are discharged. The rules alter the ways in which we provide “choice” to our patients.  In this program we will start by reviewing the current rules for discharge planning. Are you compliant with these rules? Family caregivers and physicians are expected to be much more involved than they have in the past. Be sure you know the old rules and the new rules so that your practice will be current and legal! We will review strategies for integrating these requirements into your daily practice.

 

Learning Objectives

  1. Discuss the Conditions of Participation and their relevance o case management.
  2. Review the current rules for discharge planning under the CMS Conditions of Participation
  3. Understand the new rules for discharge planning that went into effect in 2020.
  4. Identify strategies for being compliant with the new rules.
  5. Discuss the new roles for patients and families in discharge planning.
  6. Review the enhanced role for the physician in discharge planning.
  7. Understand the documentation requirements under the new discharge planning rules.

 

Areas Covered

  • Conditions of Participation (CoP) for Medicare
  • Current CoP for Discharge Planning
  • New rules for 2020
  • Strategies for managing the Discharge Planning CoP
  • The role of the physician in discharge planning
  • How to maintain compliance
  • Integrating patients and families into the discharge planning process

 

Targeted Audience

  • Director of Case Management
  • Director of Social Work
  • Case Managers
  • Social Workers
  • Vice President of Case Management
  • Directors of Nursing
  • Directors of Compliance
  • Directors of Finance
  • Directors of Nursing

Speaker

Toni G. Cesta, Ph.D., RN, FAAN is Partner and Health Care Consultant in Case Management Concepts, LLC, a consulting company which assists institutions in designing, implementing and evaluating acute care and community case management models, providing on-site education to case management staff, and strategies for assisting health care organizations in improving their case management department’s efficiency and effectiveness.

The author of nine books, and a frequently sought after speaker, lecturer and consultant, Dr. Cesta is considered one of the primary thought leaders in the field of case management.

Dr. Cesta writes a monthly column called “Case Management Insider” in the Hospital Case Management journal in which she shares insights and information on current issues and trends in case management.

Prior to her current work as a case management consultant, Dr. Cesta was Senior Vice President – Operational Efficiency and Capacity Management at Lutheran Medical Center in Brooklyn, New York. She was responsible for case management, social work, discharge planning, utilization management, denial management, bed management, the patient navigator program, the clinical documentation improvement program and systems process improvement.  Prior to her position as Senior Vice President at Lutheran Medical Center, Dr. Cesta has held positions as Corporate Vice President for Patient Flow Optimization at the North Shore – Long Island Jewish Health System and Director of Case Management, Saint Vincents Catholic Medical Centers of New York, in New York City and also designed and implemented a Master’s of Nursing in Case Management  Program and Post-Master’s Certificate Program in Case Management at Pace University in Pleasantville, New York.  Dr. Cesta completed seven years as a Commissioner for the Commission for Case Manager Certification.

Dr. Cesta has presented topics on case management at national and international conferences and workshops.  Her books include “Nursing Case Management: From Essentials to Advanced Practice Applications”, “The Case Manager’s Survival Guide: Winning Strategies in the New Healthcare Environment”, “The Case Manager’s Survival Guide: Winning Strategies for Clinical Practice”, “Survival Strategies for Nurses in Managed Care” and “Core Skills for Hospital Case Managers”.

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