Discharge planning steps, level-of-care determination, and post-acute placement concepts tested on the CCM certification exam.
35 cards · basic cards · AI-written, checked twice. Edit anything.
- What is the primary goal of discharge planning?
- To ensure a safe, appropriate transition to the next level of care.
- Which federal regulation requires hospitals to have a discharge planning process for Medicare patients?
- CMS Conditions of Participation (CoP) for discharge planning.
- How many consecutive inpatient days must a Medicare beneficiary have to qualify for SNF coverage?
- 3 days (the 3-day qualifying inpatient stay).
- A patient placed in ____ status is classified as outpatient rather than inpatient.
- observation
- IRF
- Inpatient Rehabilitation Facility
- LTACH
- Long-Term Acute Care Hospital
- What is the minimum average length of stay for a facility to be classified as an LTACH under Medicare?
- Greater than 25 days.
- Name a widely used clinical criteria set for determining medical necessity of a level of care.
- InterQual or MCG (Milliman Care Guidelines).
- What term describes a patient who can leave home only with considerable and taxing effort, a requirement for Medicare home health eligibility?
- Homebound status.
- After the first two 90-day hospice benefit periods, what length are subsequent Medicare hospice benefit periods?
- Unlimited 60-day periods.
- What is the term for temporary care given to relieve a primary caregiver?
- Respite care.
- What assessment measures a patient's ability to perform basic self-care tasks like bathing and dressing?
- Activities of Daily Living (ADL) assessment.
- What assessment measures more complex tasks like managing finances or medications?
- Instrumental Activities of Daily Living (IADL) assessment.
- What standardized notice must hospitals give Medicare inpatients explaining their discharge appeal rights?
- Important Message from Medicare (IM).
- Which organization reviews a Medicare patient's appeal of a discharge decision?
- The Quality Improvement Organization (QIO).