CMS SOM App. A, Tag A-0819

plan, the patient’s physician may request a discharge plan. In such a case, the hospital

must develop a discharge plan for the patient.

Interpretive Guidelines §482.43(c)(2)

If a patient is not identified through the hospital’s discharge planning evaluation process as

requiring a discharge plan, the patient’s physician may nevertheless request a discharge plan.

The hospital must develop a discharge plan when requested to do so by the patient’s physician.

If the hospital’s policies and procedures call for a discharge plan for every hospital inpatient,

then it is not necessary to include a separate provision in those policies requiring development of

a plan upon physician request, since such a provision would be superfluous.

Survey Procedures §482.43(c)(2)

• Review the hospital’s discharge planning policies and procedures to determine whether it

requires the development of a discharge plan for all inpatients, or only for those identified as

needing a plan through a risk-based identification and evaluation process.

• If the hospital does not require a discharge planning evaluation for all inpatients:

• Does the hospital have a standard process for notifying physicians that they may request a

discharge plan evaluation and that the hospital will develop a plan upon request?

• Interview attending physicians to see if they are aware they can request a discharge plan.

If they are not aware they can request a discharge plan, can the hospital provide evidence

of how they inform the medical staff about this?