Discharge, Transfer and Discharge for Cause
Sets out the only reasons the Agency may discharge a patient, the steps required before a discharge for cause, the physician discharge order, discharge planning for patients who are no longer terminally ill, the Texas written notice and its timing, the Medicare notice of non-coverage and notice of termination, the discharge summary, and transfers to other providers.
About this policy
- Policy number
- TX-HSP-DC-01
- Version
- 1.0
- Main rule
- 42 CFR §418.26
- Library
- Texas hospice · 59 policies
- Category
- Hospice care
- Sections
- 24
In short
- We can discharge a patient only if they move away or go to another hospice, are no longer terminally ill, or for cause after every required step.
- Never discharge a patient because their care is costly or because they use the services they need.
- Before a discharge for cause, tell the patient it is being considered, try hard to fix the problem and write everything down.
- The medical director must sign a written discharge order first. Ask the patient’s own doctor for input.
- Hand the written notice to the patient at least five days before discharge. Medicare patients who are no longer terminally ill also get the Medicare notice at least 2 days before.
- Send the discharge summary to the patient’s doctor or the new provider.
What's inside
24 sections. The full text comes with the One-time Policy Pack.
- Terms of Reference
- 1. Purpose
- 2. Scope
- 3. Definitions
- 4. Policy Statement (42 CFR §418.26; 26 TAC §558.859, §558.295)
- 5. Reasons for Discharge
- 6. Discharge for Cause
- 7. Discharge Planning When the Patient Is No Longer Terminally Ill
- 8. Physician Discharge Order
- 9. Notices
- 9.1 Texas written notice (26 TAC §558.295)
- 9.2 When advance notice is not required
- 9.3 Medicare notice of non-coverage
- 9.4 Notice of termination to the Medicare contractor
- 10. Discharge Summary and Records
- 11. Patients Leaving the Service Area
- 12. Effect of 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
- Why was this patient discharged? Show me the written physician discharge order and the attending physician’s input.
- This patient was discharged for cause. Show me that you advised the patient, tried to resolve the problem, checked it was not about use of necessary services, and documented it.
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