CMS SOM App. B, Tag G1022

The record must include:]

(6)(i) A completed discharge summary that 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 HHA (if any) within 5 business days

of the patient’s discharge; or

(ii) A completed transfer summary that is sent within 2 business days of a planned

transfer, if the patient’s care will be immediately continued in a health care facility;

or

(iii) A completed transfer summary that 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 HHA becomes aware of the transfer.

Interpretive Guidelines §484.110(a)(6)

Discharge summaries typically contain the following items:

• Admission and discharge dates;

• Physician responsible for the home health plan of care;

• Reason for admission to home health;

• Type of services provided and frequency of services;

• Laboratory data;

• Medications the patient is on at the time of discharge;

• Patient’s discharge condition;

• Patient outcomes in meeting the goals in the plan of care; and

• Patient and family post-discharge instructions.

A discharge summary must be 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 HHA (if any) within five (5) business days of the date of the order for

discharge from the responsible physician.

The contents of a transfer summary typically contain the same components as a discharge

summary.