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?
Show answer
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?
Show answer
CMS Conditions of Participation (CoP) for discharge planning.- How many consecutive inpatient days must a Medicare beneficiary have to qualify for SNF coverage?
Show answer
3 days (the 3-day qualifying inpatient stay).- A patient placed in ____ status is classified as outpatient rather than inpatient.
Show answer
observation- IRF
Show answer
Inpatient Rehabilitation Facility- LTACH
Show answer
Long-Term Acute Care Hospital- What is the minimum average length of stay for a facility to be classified as an LTACH under Medicare?
Show answer
Greater than 25 days.- Name a widely used clinical criteria set for determining medical necessity of a level of care.
Show answer
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?
Show answer
Homebound status.- After the first two 90-day hospice benefit periods, what length are subsequent Medicare hospice benefit periods?
Show answer
Unlimited 60-day periods.- What is the term for temporary care given to relieve a primary caregiver?
Show answer
Respite care.- What assessment measures a patient's ability to perform basic self-care tasks like bathing and dressing?
Show answer
Activities of Daily Living (ADL) assessment.- What assessment measures more complex tasks like managing finances or medications?
Show answer
Instrumental Activities of Daily Living (IADL) assessment.- What standardized notice must hospitals give Medicare inpatients explaining their discharge appeal rights?
Show answer
Important Message from Medicare (IM).- Which organization reviews a Medicare patient's appeal of a discharge decision?
Show answer
The Quality Improvement Organization (QIO).
FlashKeepers