{"ref":"MI-HSP-DC-01","title":"Discharge, Transfer and Discharge for Cause","category":"Hospice care","summary":"Sets the Agency's written discharge and transfer policy required by Mich. Admin. Code R 325.45131: the only reasons the Agency may discharge a living patient (a move out of the service area or a transfer, no longer terminally ill, or for cause), discharge planning with care planning, the four federal steps and the Michigan Medicaid rules before a discharge for cause, the written physician discharge order, the notices to the patient (including the Medicare notice of non-coverage and the expedited determination right), the notice of termination within 5 calendar days, the Medicaid discharge in CHAMPS with the signed copy, the discharge summary and referral package sent with the patient, and returning to hospice care later.","inShort":["We discharge a living patient only if the patient moves away or transfers, is no longer terminally ill, or for cause after every required step.","Never discharge because care is costly, because the patient used needed services, complained or cannot pay.","Before a discharge for cause: tell the patient, try hard to fix the problem, check it is not about needed services, and write it all down on Form DC-01-B.","Get a written physician discharge order first, and record what the attending physician said.","Give Form DC-01-A and, for Medicare, the notice of non-coverage at least 2 days before. Tell billing the same day: the Medicare notice is due within 5 calendar days and Medicaid needs a signed CHAMPS copy.","Send the discharge summary and referral package to the attending physician or new provider."],"primaryCitation":"42 CFR §418.26","citations":["Mich. Admin. Code R 325.45131","Mich. Admin. Code R 325.45169(5)","Mich. Admin. Code R 325.45241","MCL 333.21417","MCL 333.20201(2)(f), (g), (j)","Michigan Medicaid Provider Manual, Hospice, Sections 4, 4.1, 4.4, 4.5, 4.6, 4.7, 5.4 and 7.1"],"federalCitations":["42 CFR §418.26","42 CFR §418.104(e)","42 CFR §418.100(d)","42 CFR §405.1200","42 CFR §405.1202"],"surveyorAsks":["Show me the physician's discharge order and the attending physician consultation for this live discharge.","For this discharge for cause, show me how you told the patient, what you did to resolve the problem, and how you made sure the discharge was not because of the services the patient needed."],"forms":[{"ref":"MI-HSP-DC-01-A","title":"Notice of Hospice Discharge or Transfer"},{"ref":"MI-HSP-DC-01-B","title":"Discharge for Cause Review"}],"headings":["Terms of Reference","1. Purpose","2. Scope","3. Definitions","4. Policy Statement (42 CFR §418.26)","5. Reasons for Discharge","6. Discharge Planning for Every Patient","7. Discharge When the Patient Is No Longer Terminally Ill","8. Discharge for Cause","9. Moves and Transfers","10. Physician Discharge Order","11. Notices","11.1 Notice to the Patient","11.2 Medicare Notice of Non-Coverage and Expedited Determination","11.3 Notice of Termination to the Medicare Contractor","11.4 Michigan Medicaid Discharge in CHAMPS","11.5 Complaints and Appeals","12. Discharge Summary, Referral Package and Records Sent","13. Medicines and Equipment at Discharge","14. Effect of Discharge and Returning to Hospice","15. Responsibilities","16. Records and Compliance Monitoring","17. Staff Training","18. References","19. Related Policies and Forms","20. Approval","21. Revision History"],"version":"1.0","sample":false,"pack":"mi-hospice","state":"Michigan","service":"Hospice","guides":[{"path":"/guides/hospice-policies/","h1":"What policies are required for hospice?"},{"path":"/guides/hospice-conditions-of-participation/","h1":"Hospice Conditions of Participation: which policies each one needs"}],"agency":{"name":"Sample Agency","legalName":"Sample Agency, LLC","logo":null}}