Discharge Management

Patient information on discharge management pursuant to § 39 Sect. 1a SGB V 9 German Social Security Act)

What is the purpose of discharge management?

Upon conclusion of the treatment at the hospital, patients are discharged. In certain cases, additional support is required to safeguard the treatment result after the hospital stay ends. Respective follow-up treatment may for instance include medical or nursing care, which is provided out-patient or at in-patient rehabilitation or skilled nursing facilities. However, the setting up of appointments with doctors, physical therapists, nursing services or self-help groups as well as support with the application for services from health or nursing care insurance may also be part of this subsequent assistance.  

German law requires the hospital to prepare the discharge of patients from the hospital. The objective of discharge management is to ensure the uninterrupted provision of follow-up services to the patient. For this purpose, the hospital determines whether and which medical or nursing care measures are required subsequent to the hospital stay and initiates these services already while the patient is still hospitalized. These measures are, for instance, initiated, based on doctor’s orders, by social service staff members, home nursing transfer services (Pflegeüberleitung nach Hause = PnH), Family Care, case management or ergo therapists.  If it is necessary for the immediate follow-up care after the hospital stay, it is also possible to prescribe small amounts of medications, medicines, medical implements, social therapy services and domestic nursing care. It is also possible to designate the patient as temporarily disabled. If necessary, the health / care insurance provider also assists with discharge management services.

The hospital will brief and consult patients on all discharge management measurements. All planned activities are coordinated with the patients. If patients request it, their family members or persons of reference will be involved in the information briefings and consultations.

Why is a declaration of consent required?

German law mandates that the patient’s written declaration of consent must be provided for the performance of discharge management services and the support of the health / care insurance with these measures.

In conjunction with discharge management it may become necessary that the hospital contacts physicians, medical service providers (e.g. physical therapists or ergo therapists) or suppliers of medical implements and/or with the health or care insurance of the patient. In this context, it may be necessary that patient data is sent to these parties for these purposes. However, this is contingent upon the patient’s consent. It may be given on the attached declaration of consent, which the patient uses to consent to discharge management and the affiliated transfer of data. It may also be used to consent to the assistance of the discharge management procedures by the health / care insurance and the related transfer of data.

Discharge management via “agents” outside of the hospital

Hospitals may assign responsibilities that are part of the discharge management to doctor’s offices or facilities or doctors/facilities that hold power of attorney. Lawmakers have made this option available. If this type of discharge management should be considered for any possibly required follow-up services, patients will be separately informed and their consent will be requested.

What happens if discharge management is not supposed to be provided?

If patients request not to participate in discharge management services and/or do not want the assistance of their health / care insurance, patients withhold their consent. If despite an existing need discharge management is not implemented this may result in follow-up services not being initiated or beginning in a timely manner.  The filing of later applications for services from health / care insurance may result in the establishment of the service entitlement at a later time.

What if the patient wishes to revoke consent he/she has already given?

If patients have already given their written consent to the performance of discharge management and wish to retract their consent, they have the option to do so in writing at any time.

• If the revocation refers to the performance of discharge management overall, they have to declare their complete revocation vis-à-vis the hospital.
• If the revocation refers only to the consent to the support of discharge management by the health / care insurance, they have to declare their revocation in writing vis-à-vis the health / care insurance.

Depending on the revocation, it is possible that despite needs discharge management cannot be performed and/or supported by the health / care insurance. this may result in follow-up services not being initiated or beginning in a timely manner.  The filing of later applications for services from health / care insurance may result in the establishment of the service entitlement at a later time.

If you have questions regarding discharge management, the hospital or health / care insurance will be pleased to provide additional information.