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April 2005 Back to Table of Contents Back to Archives Main Page Section: Being Well Quick Hospital Discharges By Toby Laping, Ph. D., C.S.W., Private Care Manager
In the last several weeks, we’ve had two calls from families of people who had been hospitalized and then were discharged to sub-acute nursing home units for rehabilitation. In both cases, the patients were discharged after two days in the hospital. The families didn’t know what those decisions would cost them. They weren’t aware that in order to get Medicare coverage in a nursing home, it’s necessary to have a hospital stay of at least three days within 30 days of the nursing home admission. The nursing homes knew the rules; they should not have accepted those patients until the next day. The hospital discharge planner knew better but she wanted the patients out. In one case, the patient was on Medicaid and so it didn’t affect the patient’s pocketbook. Instead, the nursing home bill was picked up by Medicaid. You can’t live in Erie County these days without thinking of this as an unnecessary Medicaid expense. The other patient had to pay out-of-pocket for his nursing home rehabilitation stay although he should have been covered by Medicare and his Blue Cross. Blue Cross wouldn’t pay without Medicare coverage, and this patient didn’t meet the Medicare requirement of a three day hospital stay. The discharge planner from the hospital and the admissions people at the nursing homes knew better. The hospital was so eager for a quick discharge that the rights of their patients were overlooked. The families were led astray by not being given necessary information. The families didn’t know they could have held off the discharge until the next day. They, and this community, would have been better off. Hospital discharge planners work for hospitals. They need to provide a safe discharge plan as quickly as possible. By contrast, it happens on occasion that families and/or patients are best served by slowing down a discharge for a day or two. Perhaps the patient is going home and the home health care plans need to be put into place prior to discharge; further, suppose the home care agency won’t be able even to open the case for some days. In that event, know that you’re likely to find yourself at home with no services for a while if you leave the hospital immediately. If you can manage that way, fine. If you can’t, you’re likely to be put to the test if you leave when you’re asked to leave. Or, perhaps you’ve been promised a bed in the specific nursing home of your choice, but that bed won’t be available for two days. Or, you may feel that you’re still acutely ill or that more tests need to be finished before you leave the hospital. You should know that you can delay a hospital discharge for a day or two. It’s never a good idea to hang around a hospital; they’ve been called good places to go when you’re very ill and good places to get sick again once you’ve recovered. Also, it can be very expensive for the hospital to keep you longer than they feel is necessary. However, there are times when it makes sense to stay and you need to know your rights. More about this in a future article. www.wnycaremanager.com back to top back to table of contents Current Issue | About Forever Young | Where to Find | Advertise | Our Advertisers | Community Calendar | Contest | Clubs | Contact Us | Archives | Home |
