Discharge Planning Workshop For Critical Access Hospital

Recording of sessions will available to those that cannot attend the live session.   

Discharge planning has become more than just the movement of the patient out of the hospital.  It is a “process” that starts at the point of admission and follows beyond discharge and through the continuum of care. The Centers for Medicare and Medicaid Services have proposed more “teeth” to the process, with updates to the discharge planning section of the Conditions of Participation.  This workshop will cover a wide-ranging list of topics related to discharge planning.  Effective discharge plans can improve your hospital’s value-based reimbursement.  We will review how to engage with other members of the interdisciplinary care team in the process of planning for the patient’s movement across the continuum including verbal and written hand-off communication. Discharge planning is no longer a destination but a process!  Learn how to be certain that your processes address the complexities of the new healthcare environment as well as the regulatory requirements

OBJECTIVES

1. Understand discharge planning as a process not an outcome.
2. Discuss the new CMS changes related to transitional and discharge planning and how they can impact your practice.
3. Identify best practice strategies for transitioning patients across the continuum of care.
4. Review examples of case management assessments that meet regulatory requirements from CMS.
5. Understand the new requirements from CMS related to Social Drivers of Health and how to assess patients for these drivers.
6. Apply the regulatory requirements related to discharge planning.
7. Identify strategies that can be used to reduce your hospital’s readmission rate.
8. Review definitions and examples of the continuum of care and how it applies to your discharge planning process.
9. Discuss the levels of care, the differences between them, and the patient requirements for acceptance into one of these levels.
10. Identify specialty roles in case management that support the discharge and transitional planning processes.
11. Review strategies for working with post-acute providers.
12. Participate in open discussion of discharge planning issues identified by attendees.

Instructor: Toni Cesta & Bev Cunningham, Principals at Case Management Concepts, LLC

Target Audience:  RN's, Social Work Case Manager, Discharge Planners, or anyone upgrading their role in discharge planning.

• Handouts will be shasred prior to each webinar
• The recording link for each session will be available to all registrants for 60 days

February 6, 2025 12:00 - 1:30 pm - Session 1

Webinar 1:  Best Practices in Managing Discharge Planning

This webinar will discuss what discharge planning is and the best-practice processes that can be applied to achieve the best outcomes, including a timely and safe discharge plan. After reviewing this process step-by-step, we will discuss the ways in which discharge planning intersects with the other case management roles, including utilization management, care coordination and others.  From here will move to a discussion of transitional planning, what it is and how it can be used effectively to ensure that your patient have a smooth move out of the acute care setting and to the next level of care. We will conclude webinar 1 with a discussion of the roles of the Transitions Case Manager.

February 20, 2024 12:00 - 1:30 pm - Session 2

Webinar 2:  Case Management Assessments and Other Regulatory Requirements

This second webinar will review the requirements from CMS related to assessments. The initial assessment is used to begin the discharge planning process, but it can be much more than that. Forward-thinking application of a comprehensive tool will be shared.  We will then review the social drivers of health assessments  required by CMS and examples of tools that can be used to meet   these requirements.  Both assessment tools are the foundations for your discharge planning processes.  We will move on to other regulatory requirements related to discharge planning including the Choice List, the patient appeal process and others.

February 27, 2025 12:00 - 1:30 pm - Session 3 

Webinar 3:  Levels of Care and How They Relate to Discharge Planning

This third webinar will review the definitions and applications of the continuum of care as it relates to the discharge planning process.  Selecting the correct next level of care is critical and must involve the patient and the family in the selection process.  We will discuss the role of discharge planning in the emergency department, thinking of the ED as an exit point as well as an entry point to the hospital.  To have the  most effective working relationships with post-acute care providers requires an understanding of the strategies that hospital case management can use to have the most seamless transfer process as well as less returns to the emergency department. We will finish with a discussion of discharge hand-offs and how  tools that standardize the process can also reduce readmissions and/or poor outcomes in the community.

March 6, 2025 12:00 - 1:30 pm - Session 4

Webinar 4:  Workshop and Case Studies

Webinar 4 provides the attendees with the opportunity to submit specific questions or their own case studies for discussion. Responses to polling questions submitted prior to the webinar will be reviewed and discussed as well.  These takeaways will augment the content provided in the first three webinars. Audience participation is encouraged and welcomed!

 Continuing Education:  Clock Hours:  6.0

Application is being made to the following agencies: MN Board of Nursing & MN Board of Social Work. The # of CEU’s will be indicated on the certificate of attendance provided to each participant who attends the session.  To check on final hours awarded, please contact the Medi-Sota office.

Registration Fees

Medi-Sota Members: $175/person                     

Non-Medi-Sota Members: $325/person

Prior to the program, you will receive an email with any additional course information. Registration Deadline: February 5, 2025 by 5pm this ensures all registrants will receive course information & any materials in a timely manner.

Cancellations must be made no later than 10 business days prior to the start of the course. The full course fee will be charged if cancellation is made in less than 10 business days. Full refunds will be given for all classes cancelled by Medi-Sota. Registration is transferable to another person.