You Can Delay An Elder's
Hospital Discharge
When It's Too Soon

Your mother (or the nurse, or the social worker) just called you from the hospital to say she is being discharged from the hospital and you should come pick her up. She can barely walk, she's too weak to go home alone, and you have no way to care for her. You're in a panic.

Maybe the discharge is planned for tomorrow...a little better, but not much.

The first thing to do is don't panic. The second thing (not) to do is go pick her up.

Here's what you should do instead:

1. Understand that hospitals must discharge patients if they no longer require that level of care, even if they are elderly and live alone. Most patients are not fully recovered when they leave the hospital. If you haven't been given the opportunity to plan for after-hospital care you may be able to buy yourself a day or two to make arrangements if you follow the rules.

2. Immediately ask a hospital representative for a written "Notice of Non-Coverage." This is a written notice that explains the reason for discharge from the hospital, the date the patient is to be discharged, and where the patient is to go after discharge.

3. Initiate an appeal to the proposed discharge. Instructions for appeal are provided on the written notice. You must call the "Quality Improvement Organization" (QIO) that will review your appeal by noon of the next business day following your receipt of the written Notice of Discharge. The telephone number and other contact information will be on the form you received. If you make your appeal before the deadline (by noon of the next business day after you receive the "Notice of Non-Coverage"), the hospital may not discharge the patient while his or her appeal is under review.

The appeal process may take a day or two, sometimes more if a weekend intervenes.

Even if the patient's appeal is denied, the patient has until noon of the day following receipt of the decision to leave the hospital.

The patient may not be charged for hospital days during the appeal process. After noon of the day following receipt of a denial the hospital may begin charging the patient. And that can cost more than $1,000 a day, so you have no time to loose in putting your plan together.

Following this process, which applies to all Medicare recipients, can buy you at least two or three days of extra time to either find another facility where the patient can continue to recover and rehabilitate, or to prepare the home for the patient's return.

If you don't feel confident that you can do this without more assistance than the hospital discharge planner can give you, now is the time to talk with a professional. An hour or two of consultation with someone who will come to the hospital, assess your loved one's needs, and help you put together a plan on the spot will be worth ten times any fee you might pay. If I'm too far away to be useful (I'm in Dallas, Texas) find a care manager near you right away and make the call.