According to the Centers for Medicare and Medicaid Services (CMS), acute care hospital readmissions may result from actions taken or omitted during a member’s initial acute care hospital stay. Historically, nearly 20% of all hospital discharges have had a readmission within 30 days.
READMISSION WITHIN 30 DAYS OF DISCHARGE
Readmission within 30 days of discharge, for the purposes of this policy, is an unplanned inpatient acute care hospital readmission within 30 days of the previous inpatient hospital stay for a condition related to the original inpatient hospital stay (e.g., same major diagnostic category [MDC], post-operative infection, sepsis, or complication diagnosis).
The 30-day readmission provision includes the day of discharge and the following 30 calendar days.
Multiple admissions under the 30-day readmission provision consist of two or more unplanned inpatient acute care hospital admissions within 30 days of discharge from the most recent inpatient hospital date of discharge and are for a condition related to the most recent inpatient hospital stay (e.g., same major diagnostic category [MDC], post-operative infection, sepsis, or complication diagnosis).