Nursing Home: Hospital Discharge Planning Part 1
I realized there is something I forgot to mention in my last blogs. It is important to write down any information you receive and who gives it to you. Make sure to get doctor's, nurses, administrators, ancillary support persons and insurance representatives names. You can get a small notebook and write all the information in it. When you can refer to a specific conversation and give the person's name, it will make a difference in getting needed action. What you will discover is there can be conflicting information when the same question is asked. So always have a pen and paper.
DISCHARGE PLANNING
Discharge planning starts from the moment of admission. Hospital and insurance companies dictate that there is a specific course of treatment and discharge not be prolonged. Until a clear picture of the medical diagnosis and treatment are available, it can seem as if the world is spinning out of control. Tests are ordered, doctors are visiting, medications are being given and it is hard to keep pace.
Unfortunately what happens is as soon as some resolution of diagnosis and treatment is clarified, discharge could be any time. I have experienced people being told discharge is going to happen the next day because the insurance won't pay since the diagnosis and treatment are clear. It may mean being transfered to a subacute rehabilitation facility. As hard as it sounds, start thinking about a discharge plan, when the flurry of the initial activity and shock begins to subside. Discharge planning translates into what will happen after the hospital stay.
Here are some tips to getting what you need.
- Immediately find out who does the discharge planning. Is it a nurse, social worker, discharge planner or case manager.
- Make the discharge planner your best friend. Let them know you want to be involved in every discussion and would like daily updates.
- A patient cannot be discharged without a credible plan in place. This means, if a subacute rehab, nursing home or assisted living placement is required, it must be done before discharge. It also means a patient cannot be sent home to an unsafe situation. A plan must be created before the discharge for a safe home environment. It all sounds logic and reasonable but I have seen people discharged with no real plan in place.
- If placement in another facility is needed, and you have no idea of what is available,ask for a list of area facilities. You can go on the web and get information or call. Speak with the intake person. You can go to www.medicare.gov for nursing home and assisted living ratings. Each state has a rating also on their state website.
- Before leaving the hospital, get a copy of the medical records. At the least, a copy of the medications and discharge plan.
- Medicare pays for 100 days of subacute care facility.
Next blog: How to assess if a home is safe for discharge and Understanding subacute rehab from function to payment.
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