title: Confusion ahead as CMS changes inpatient criteria.
abstract: In the Inpatient Prospective Payment System final rule for 2014, the Centers for Medicare & Medicaid Services established a benchmark of two midnights for an inpatient admission and issued robust requirements for documentation. Case managers must work closely with physicians to ensure that the documentation includes the expected length of stay, the rationale for hospital treatment, the treatment plan, and a written order for admission. Case managers must review every admission within 24 hours to make sure the hospital doesn't lose reimbursement. Auditors will be looking for incidents where hospitals keep patients over two midnights when it's not medically necessary in order to get inpatient reimbursement. CMS continues to emphasize quality in care.
mesh_terms: D019090:Case Management / Q000331:legislation & jurisprudence*; D014487:Centers for Medicare and Medicaid Services, U.S.; D003221:Confusion; D004608:Eligibility Determination / Q000331:legislation & jurisprudence*; D006760:Hospitalization / Q000331:legislation & jurisprudence*; D006801:Humans; D011445:Prospective Payment System / Q000458:organization & administration*; D014481:United States