“Going home tomorrow?!”

When your loved one is hospitalized, getting word of discharge “soon” can be heartening: Yay! Improvement! And it also can be distressing. Many aspects of care may drop into your hands. Mobility, incontinence, wound care, oxygen…. And you may not have the needed help lined up.

Good news: There are options. Tell the doctor and the hospital discharge planner immediately of your concerns. According to Medicare regulations, they are required to work with whoever is the “family caregiver” to come up with a safe and appropriate plan.

The hospital may pressure you. (They get paid a fixed fee, so the earlier the discharge, the more money they make.) Your relative may pressure you, too. Ask the hospital for the reasoning behind the discharge plan. Stand your ground for a wise decision about timing and aftercare. If this seems daunting, consider the advocacy services of a care manager.

There is also a formal appeal process for discharge decisions, but timing is crucial.

• Upon admission, your relative should receive an “Important Message from Medicare.” Keep this paper. It lists the agency that handles discharge appeals. If you don’t receive this document, ask for it.
• Also upon admission, ask the case manager (aka, discharge planner) how long your relative will likely be staying and if they are officially “an inpatient” or just there for “observation.” The appeal process is only for patients who have been formally admitted.
• As soon as you have safety concerns about the discharge, alert the doctor and discharge planner.
• If the hospital persists with its discharge timetable, contact the reviewing agency immediately and ask for a “fast appeal.” You can ask for a fast appeal up to the day of discharge.

A review usually takes twenty-four to forty-eight hours. Medicare will continue to pay for your loved one’s hospital stay during the review (although the deductible and usual copays still apply).

Worried about potential after-hospital duties?
Give us a call at 1-800-789-0586 (toll-free). As the Roanoke and Lynchburg experts in family caregiving, we at Gentle Shepherd Hospice can help guide you through the process to figure out the best timing and combination of support services. You don’t have to do this alone.