Patient choice at discharge: what the hospital rule requires

When home health is indicated, the discharge plan must include a list of Medicare-participating home health agencies that serve the area where the patient lives. The hospital documents in the record that the list was presented. Agencies must ask to be listed (42 CFR 482.43(d)(1)).

OceanCare Health asks to be listed by hospitals whose patients live in our service area. If your list does not include us yet, please contact our team.

The hospital must tell the patient or representative they are free to choose among participating providers and must respect their goals of care and preferences when possible. The hospital must not specify or otherwise limit the qualified agencies available (42 CFR 482.43(d)(2)).

Hospitals must help patients select a post-acute provider by sharing quality and resource-use data that is relevant to the patient's goals (42 CFR 482.43(a)(8)). For home health, that usually means the star ratings and measures on Medicare Care Compare. New agencies may not have enough data for a rating yet, which Medicare says does not mean something is wrong with the agency.

Patients in managed care plans must be told to verify which agencies are in network, and the hospital shares network information it has. The discharge plan must also identify any home health agency in which the hospital has a disclosable financial interest (42 CFR 482.43(d)(1)(ii) and (d)(3)).

We do not offer gifts, payments or anything of value in exchange for referrals, consistent with the federal Anti-Kickback Statute. What we offer is information: our service area, accepted coverage, start-of-care process and quality data once it is published.