When an elderly person is admitted to a Northshore hospital, there is a chance that they could be discharged before being ready to leave. Any senior patient admitted in the hospital has the right to contest the discharge and file a “fast appeal.” The government created new regulations on the hospital discharge process, after a lawsuit was filed against Medicare for not giving beneficiaries enough notice regarding discharge dates. The “Chicago Tribune” published an article on stopping hospital releases, and here are 4 steps they suggest you take to get the fast appeal process started.
Be Aware of Your Rights
All elderly people admitted into the hospital should get a written notice of their rights for appealing discharges after 2 days. A second notice should be given before being discharged if the patient is still in the hospital at least 5 days later.
This notice, called “Important Message from Medicare,” will provide the patient with the contact information of their Medicare Quality Improvement Organization. This organization assists patients with the fast appeals process, but also handles complaints regarding quality of care. The Quality Improvement Organization that services Illinois’ Northshore is KEPRO.
Make sure all documents provided to you by the hospital are read immediately, to ensure deadlines for filing appeals are not missed.
Get the Appeals Process Started
Senior patients are the only people qualified to take part in the fast appeals process. They can file an appeal if they do not feel ready to be discharged from the hospital. To file an appeal of a pending hospital discharge, call the Quality Improvement Organization at (855)408-8557 and let them know you are filing a fast appeal. You can call the organization at any time starting the day the discharge notice was received, until just before midnight on the day the discharge is scheduled to occur.
Those who are considered on “observation status” have a different appeals process, so it is important the patient’s status is checked regularly.
After the fast appeals process begins, the elderly patient cannot be discharged or transferred to another location until the appeal is resolved. This process takes an average of 2 days to complete. Patients will have to pay for insurance and pay money towards their deductible, but they will not be charged for the extra days spent in the hospital.
If the Quality Improvement Organization decides the discharge was appropriate after reviewing the appeal, the patient is allowed to stay in the hospital until noon the following day. Patients will not be charged for this time spent in the hospital.
In order for the appeal to be approved, doctors must agree that it is medically necessary for the senior patient to stay. Patients who are stabilized and do not have any serious symptoms will be discharged or transferred to a different facility.
Know What is Going On
It is very beneficial for the patient to have good communication with the doctors regarding the estimated length of stay in the hospital. By doing this, there is a better chance of avoiding surprise discharge notices from the hospital.
Managing and planning the transition from hospital to home care is a crucial element when it comes to a safe return home. Click here for an overview of Homewatch CareGivers Hospital Discharge Service, Planning and Home Care.