W. Va. Code R. § 64-12-14

Current through Register Vol. XLI, No. 43, October 25, 2024

Section 64-12-14 - Discharge Planning

14.1. The hospital shall have in effect a discharge planning process for post-hospital services, including hospice, which includes early assessment of the needs of each patient, particularly those with potential risk for adverse consequences upon discharge. The assessment shall be based upon the patient's functional abilities and probable environment to which the patient shall return. The hospital's policies and procedures shall be specified in writing.

14.2. A discharge needs assessment, evaluating the factors that affect the patient's need for post-hospital care, shall be performed or supervised by a registered nurse, social worker or other appropriately qualified person, as identified by hospital policy, and be completed in enough time for appropriate arrangements to be made prior to discharge. The assessment shall address the biopsychosocial needs of the patient, the level of understanding of those needs and an identification of post hospital care resources.

14.3. The hospital shall provide counseling as needed, to the patient and family members or interested persons, to prepare them for post-hospital care, including hospice services.

14.4. The hospital shall arrange for the initial implementation of the patient's discharge plan, including obtaining post-hospital services as necessary.

14.5. The hospital shall ensure that the discharge plan be reassessed, as needed, and entered into the patient's record.

14.6. The hospital shall transfer or refer patients, along with necessary medical information, to appropriate facilities, agencies, or outpatient services, as needed, for follow-up or ancillary care.

14.7. The discharge planning process shall be an integral part of the quality assessment and performance improvement program, as detailed in section 15 of this rule.

W. Va. Code R. § 64-12-14