La. Admin. Code tit. 40 § I-2709

Current through Register Vol. 50, No. 11, November 20, 2024

Section I-2709 - Discharge Planning

Discharge planning is the process of assessing a patient's need for treatment after hospitalization and effecting an appropriate and timely discharge. The hospital has major responsibility for this function with the carrier/self-insured employer promoting, monitoring, and assisting the hospital.

A. Discharge Planning Procedures

1. Discharge planning is primarily the responsibility of the hospital.

2. The carrier/self-insured employer supports discharge planning by identifying and referring patients who may need discharge planning, by assisting the hospital with information on statutory coverage and alternative providers, and by monitoring hospitals to assure that appropriate discharge planning services are provided.

3. Discharge planning cases are identified primarily by the hospital. These services may not be duplicated by the carrier/self-insured employer if they are provided by the hospital. However, in addition, the carrier/self-insured employer identifies cases through pre-admission certification, admission review, continued stay review, and other managed care activities.

4. The carrier/self-insured employer requires appropriate hospital documentation on cases processed through discharge planning.

B. Discharge Planning Preparation

1. Preparation

a. Discharge Planning Information. The carrier/self-insured employer will capture pertinent patient and provider data during the discharge planning activity. This information may be identical to that used by the carrier/self-insured employer for their other business, however it should include the statistical data elements required by the Office of Workers' Compensation Administration.

b. Screening for Cases. The carrier/self-insured employer should identify the cases that are most likely to require discharge planning. This process can be initiated during the pre-admission certification activity to identify cases and to notify the hospital to begin discharge planning as soon as possible. The sooner the hospital discharge planner knows the patient's needs, the more likely it is that unnecessary days will be avoided.

2. Implementation

a. Telephone Inquiry Service. Telephone numbers should be published in educational materials and standard form letters to hospitals and claimants. This telephone service should provide for prompt response to general inquiries about the discharge planning process.

b. Monitoring the Hospital. The carrier/self-insured employer should monitor the hospital's discharge planning activity on a case-by-case basis and an aggregate basis at regular intervals. Monitoring ensures that Louisiana workers' compensation claimants receive quality care. As part of the monitoring effort, the carrier/self-insured employer may require documentation from the medical records or abstract material on patients. Documentation should include information on the cases the hospital has seen, the discharge planning activity, the results of the activity and the problems encountered.

La. Admin. Code tit. 40, § I-2709

Promulgated by the Department of Employment and Training, Office of Workers' Compensation, LR 17:263 (March 1991), repromulgated LR 17:653 (July 1991).

AUTHORITY NOTE: Promulgated in accordance with R.S. 23:1291.