Q: How can I ensure my loved one has a safe discharge plan after a hospitalization?
A: Effective discharge planning is essential to ensure that your loved one receives the care they need as they transition from the hospital to home or another facility.
Medicare requires that hospitals provide a written discharge plan before patients leave the hospital. The plan assesses and identifies what the patient’s needs will be and arranges for the appropriate care. The discharge plan involves not only the patient and family members, but also doctors and members of the hospital staff.
While the hospital’s main goal should be to return the patient home, it may be necessary to move them to a skilled nursing facility. Skilled nursing facilities provide nursing and rehabilitative services to patients on a short-term or long-term basis.
Skilled nursing care is provided by trained and licensed professionals such as nurses and therapists. They provide services like wound care, medication administration, and therapy to patients who are recovering from surgery, injury, or acute illness. Skilled nursing care is also suitable for people with chronic conditions who need constant medical supervision.
Part of a successful discharge plan identifies which post-discharge services will be covered by insurance (e.g. Medicare). Medicare covers skilled nursing care only when specific admission requirements are met and only for a short period of time:
• The individual has Medicare Part A (hospital insurance) with a valid benefit period. The benefit period will start from the date of admission to a hospital or skilled nursing facility and last for up to 60 days after the end of the stay.
• The individual has a qualifying hospital stay. This generally means at least three in- patient days in a hospital.
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• Admission is to a skilled nursing facility certified by Medicare. A skilled nursing facility must meet strict criteria to maintain its Medicare certification.
Usually, skilled nursing services covered by Medicare include room charges, meals, nutritional counseling, costs of medication, medical supplies, medical social services, and ambulance transportation. Medicare also covers rehabilitative services, such as physical therapy, respiratory therapy, and speech therapy.
Hospital staff is required to educate and train you and any caregivers about a patient’s needs by providing a clear list of instructions for their care, information about medications, and referrals. Equipping yourself with this information can help ensure that your loved one is discharged as safely and cost-effectively as possible.
Brittni Sullivan, Esq. and Dylan Stevens, Esq. are attorneys at Burner Law Group, P.C. focusing their practice areas on Estate Planning and Elder Law. Burner Law Group P.C. serves clients from Manhattan to the east end of Long Island with offices located in East Setauket, Westhampton Beach, New York City and East Hampton.