Specifications Manual for Joint Commission National Quality Measures (v2021A)
Posted: 7/29/2020
Home » Reason for Not Discharging Patient to Home

Release Notes:
Data Element
Version 2021A

Name:Reason for Not Discharging Patient to Home
Collected For: THKR-IP-3, THKR-OP-3
Definition:Reasons for not discharging the patient to home.
Question:Is there documentation of a medical or social reason for not discharging the patient to home?
Format:
Length:1
Type:Alphanumeric
Occurs:1
Allowable Values:

Y (Yes)   There is documentation of a medical/social reason for not discharging the patient to home.

N (No)   There is no documentation of a medical/social reason for not discharging the patient to home or unable to determine from medical record documentation.
Notes for Abstraction:
  • Reasons for not discharging the patient to home must be documented by a physician/APN/PA/nurse/social worker/care manager/discharge planner/physical therapist/occupational therapist.
  • Reasons do NOT need to be documented at discharge or otherwise linked to the discharge timeframe: Documentation of reasons anytime during the encounter are acceptable.
    Example:
    • Mid-hospitalization note stating “patient will rehab at SNF due to lack of support at home”, select “Yes”.
  • If reasons are not mentioned in the context of discharge to home, do not make inferences.
    Example:
    • H&P states “patient lives alone”, select “no”.
    • H&P states “patient lives alone and therefore will rehab at SNF”, select “yes”.
  • In the absence of a medical/social reason documented by the physician/APN/PA/nurse/social worker/care manager/discharge planner/physical therapist/occupational therapist, patient/family/caregiver refusal is not an acceptable stand alone reason for not discharging the patient to home. The healthcare team has an opportunity to educate and influence the patient regarding recuperation at home as this is the safest option for most patients. Additionally, the healthcare team can play a role in assessing the home situation preoperatively and assuring the appropriating resources are in place postoperatively in the home for a safe recovery.
Suggested Data Sources:
  • Consultation notes
  • History and physical
  • Nursing notes
  • Nursing admission assessment
  • Progress notes
  • Physician orders
  • Physician's notes
  • Discharge summary
  • Care management notes
  • Discharge Planning Notes
  • Preadmitting notes
  • Social work notes
  • Therapy notes (e.g., physical therapy, occupational therapy, kinesiotherapy)
Additional Notes:
Guidelines for Abstraction:
Inclusion Exclusion
None Patient/Family/Caregiver Refusal

Reason for Not Discharging Patient to Home
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Specifications Manual for Joint Commission National Quality Measures (v2021A)
Discharges 01-01-21 (1Q21) through 06-30-21 (2Q21)

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