When to give a HINN

When pt is no longer meeting IP criteria for Medicare ( no longer has medical necessity to be in hospital)... pt has 3 days to respond to your letter of intent to discharge, or they are responsible for payment after that date, I only have had to do it once... pt was hospice candidate, physician had made referral, and son was basically refusing to work with us on dc planning to hospice, NH, any other level of care... once he got the HINN letter, he was ready to move...