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Specifications Manual for Joint Commission National Quality Measures (v2016B1)
Home » Discharge Code

Release Notes:
Data Element
Version 2016B1

Data Element Name: Discharge Code
Collected For: ACHFOP,
Definition:The final place or setting to which the patient was discharged from the outpatient setting.
Suggested Data Collection Question:What was the patient’s discharge code from the outpatient setting?
Format:
Length:2
Type:Alphanumeric
Occurs:1
Allowable Values:


1    Home
2    Hospice - Home
3    Hospice – Health Care Facility
4a    Acute Care Facility- General Inpatient Care
4b    Acute Care Facility- Critical Access Hospital
4c    Acute Care Facility- Cancer Hospital or Children’s Hospital
4d    Acute Care Facility – Department of Defense or Veteran’s Administration
5    Other Health Care Facility
6    Expired
7    Left Against Medical Advice/AMA
8    Not Documented or Unable to Determine (UTD)
Notes for Abstraction:
  • If documentation is contradictory, use the latest documentation. If there is documentation that further clarifies the level of care that documentation should be used to determine the correct value to abstract.
    Example:
    • Nursing discharge note documentation reflects that the patient is being discharged to “XYZ” Hospital. The Social Service notes from the day before discharge further clarify that the patient will be transferred to the rehab unit of “XYZ” Hospital, select value “5”.
  • If the medical record states only that the patient is being discharged to another hospital and does not reflect the level of care that the patient will be receiving, select value “4a”.
  • To select value “7” there must be explicit documentation that the patient left against medical advice.
    Examples:
    • Progress notes state that patient requests to be discharged but that discharge was medically contraindicated at this time. Nursing notes reflect that patient left against medical advice and AMA papers were signed, select value “7”.
    • Physician order written to discharge to home. Nursing notes reflect that patient left before discharge instructions could be given, select value “1”.
Suggested Data Sources:

  • Discharge instruction sheet
  • Emergency Department Record
  • Nursing discharge notes
  • Physician orders
  • Progress notes
  • Transfer record
Additional Notes: Excluded Data Sources:
  • UB-04
Guidelines for Abstraction:
Inclusion Exclusion
For Value 1:
  • Assisted Living Facilities
  • Court/Law Enforcement – includes detention facilities, jails, and prison
  • Home – includes board and care, foster or residential care, group or personal care homes, and homeless shelters
  • Home with Home Health Services
  • Outpatient Services including outpatient procedures at another hospital, Outpatient Chemical Dependency Programs and Partial Hospitalization

For Value 3:
  • Hospice Care - General Inpatient and Respite
  • Hospice Care - Residential and Skilled Facilities
  • Hospice Care - Other Health Care Facilities (excludes home)

For Value 5:
  • Extended or Intermediate Care Facility (ECF/ICF)
  • Long Term Acute Care Hospital (LTACH)
  • Nursing Home or Facility including Veteran’s Administration Nursing Facility
  • Psychiatric Hospital or Psychiatric Unit of a Hospital
  • Rehabilitation Facility including Inpatient Rehabilitation Facility/Hospital or Rehabilitation Unit of a Hospital
  • Skilled Nursing Facility (SNF), Sub-Acute Care or Swing Bed
  • Transitional Care Unit (TCU)

None

Discharge Code
Specifications Manual for Joint Commission National Quality Measures (v2016B1)
Discharges 01-01-17 (1Q17) through 06-30-17 (2Q17)
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