Page 83 - Business Development Orientation Binder

Applies to: VNSNY Certified Home Health Agency
Service: VNSNY Certified Home Health Agency
Policy Section: CHHA Policies
Number: CP.208
Page 1 of 2
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TITLE: Discharge/Transfer /Episode Summary Reports

PURPOSE

To comply with State and Federal laws and regulatory that requires completed a
discharge summary be sent to the primary care practitioner or other health care
provider and a completed transfer summary to be sent to the health care facility
the patient is transferred to.

To define the process of generating and sending end of summary reports at
different time points as required by regulations.

POLICY
1. Episode Summary Report is sent to the primary care practitioner or other
health care professional who will be responsible for providing care and
services to the patient after discharge from the agency within 5 business
days of the patient’s discharge.
2. Episode Summary Report is sent within 2 business days of a planned
transfer, if the patient’s care will be immediately continued in a health care
facility.
3. Episode Summary Report is sent within 2 business days of becoming aware
of an unplanned transfer, if the patient is still receiving care in a health care
facility at the time when the agency becomes aware of the transfer.
4. End of Episode Summary Reports are generated based on clinical
documentation when patients are discharged from services or transferred to
inpatient facility.

DISCHARGE AND TRANSFER EPISODE SUMMARIES INCLUDE:

1. Admission and discharge/transfer dates;
2. Physician responsible for the home health plan of care;
3. Reason for admission to home care
4. Summary and type of services provided
5. Medications the patient is on at the time of discharge or transfer
6. Patient discharge condition
7. Patient outcomes in meeting the goals in the plan of care
8. Description of any remaining needs for patient care and supportive services
9. Patient and family post discharge instructions.
Responsibility: Quality Management Services-Homecare
Policy Dates:
Revised: 6/2015, 6/2016, 06/2017, 12/2018
Approved: SVP, Patient Care Services; Professional Advisory Committee