Discharge, Termination of Services and Transfer
Sets when the Agency may discharge a living patient (move out of the service area or transfer, no longer terminally ill, or for cause after the required steps), the written physician discharge order, the North Carolina 48-hour advance notice, the Medicare non-coverage notice and appeal rights, discharge planning, notices to Medicare and NC Medicaid, and the discharge summary sent to the receiving facility or attending physician.
About this policy
- Policy number
- NC-HSP-DC-01
- Version
- 1.0
- Main rule
- 10A NCAC 13K .0601(5)
- Library
- North Carolina hospice · 60 policies
- Category
- Hospice care
- Sections
- 22
In short
- We discharge a living patient only for a reason the rules allow, never because of cost or use of hospice services.
- Get a written discharge order from a hospice physician and consult the attending physician first.
- Give written notice (Form NC-HSP-DC-01-A) at least 48 hours before services end, unless the patient agrees or there is danger.
- For Medicare patients no longer terminally ill, also give the Medicare notice at least 2 days before, with appeal rights.
- Before discharge for cause, warn the patient, try hard to fix the problem and document it.
- Send the discharge summary to the doctor or new provider within 2 business days.
What's inside
22 sections. The full text comes with the One-time Policy Pack.
- Terms of Reference
- 1. Purpose
- 2. Scope
- 3. Definitions
- 4. Policy Statement (10A NCAC 13K .0601(5))
- 5. Reasons for Discharge
- 5.1 What is not a reason to discharge
- 6. Discharge for Cause
- 6.1 Approval and safety
- 7. Discharge Planning When the Patient Is No Longer Terminally Ill
- 8. Medicare Notice and Appeal Rights
- 9. The Discharge Order and Advance Notice
- 10. Effect of Discharge and Notices to Payers
- 11. Discharge Summary and Records
- 12. After Discharge
- 13. Responsibilities
- 14. Records and Compliance Monitoring
- 15. Staff Training
- 16. References
- 17. Related Policies and Forms
- 18. Approval
- 19. Revision History
An inspector may ask
- Show me the written physician discharge order for this live discharge, and the attending physician's input.
- When did the patient receive written notice of the discharge? Was it at least 48 hours in advance?
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