Louisiana Administrative Code
Title 40 - LABOR AND EMPLOYMENT
Part I - Workers' Compensation Administration
Subpart 2 - Medical Guidelines
Chapter 27 - Utilization Review Procedures
Section I-2709 - Discharge Planning
Universal Citation: LA Admin Code I-2709
Current through Register Vol. 50, No. 9, September 20, 2024
Discharge planning is the process of assessing a patient's need for treatment after hospitalization and effecting an appropriate and timely discharge. The hospital has major responsibility for this function with the carrier/self-insured employer promoting, monitoring, and assisting the hospital.
A. Discharge Planning Procedures
1. Discharge planning is primarily
the responsibility of the hospital.
2. The carrier/self-insured employer supports
discharge planning by identifying and referring patients who may need discharge
planning, by assisting the hospital with information on statutory coverage and
alternative providers, and by monitoring hospitals to assure that appropriate
discharge planning services are provided.
3. Discharge planning cases are identified
primarily by the hospital. These services may not be duplicated by the
carrier/self-insured employer if they are provided by the hospital. However, in
addition, the carrier/self-insured employer identifies cases through
pre-admission certification, admission review, continued stay review, and other
managed care activities.
4. The
carrier/self-insured employer requires appropriate hospital documentation on
cases processed through discharge planning.
B. Discharge Planning Preparation
1. Preparation
a. Discharge Planning Information. The
carrier/self-insured employer will capture pertinent patient and provider data
during the discharge planning activity. This information may be identical to
that used by the carrier/self-insured employer for their other business,
however it should include the statistical data elements required by the Office
of Workers' Compensation Administration.
b. Screening for Cases. The
carrier/self-insured employer should identify the cases that are most likely to
require discharge planning. This process can be initiated during the
pre-admission certification activity to identify cases and to notify the
hospital to begin discharge planning as soon as possible. The sooner the
hospital discharge planner knows the patient's needs, the more likely it is
that unnecessary days will be avoided.
2. Implementation
a. Telephone Inquiry Service. Telephone
numbers should be published in educational materials and standard form letters
to hospitals and claimants. This telephone service should provide for prompt
response to general inquiries about the discharge planning process.
b. Monitoring the Hospital. The
carrier/self-insured employer should monitor the hospital's discharge planning
activity on a case-by-case basis and an aggregate basis at regular intervals.
Monitoring ensures that Louisiana workers' compensation claimants receive
quality care. As part of the monitoring effort, the carrier/self-insured
employer may require documentation from the medical records or abstract
material on patients. Documentation should include information on the cases the
hospital has seen, the discharge planning activity, the results of the activity
and the problems encountered.
AUTHORITY NOTE: Promulgated in accordance with R.S. 23:1291.
Disclaimer: These regulations may not be the most recent version. Louisiana may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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