Doctor’s Diary August 28, 2018: Know your Medicare rights

(Snippets from the frontline)

Know your Medicare rights

Hospitals generally treat Medicare patients like herding cattle:  “get ‘em in, get ‘em out.”  A patient is admitted, diagnosis made, treatment started, then discharged home.  Often, they are herded to a nursing home to complete therapy.  Moo.

The most dangerous time is around the fourth day of hospitalization (because of the Medicare DRG payment schedule) when hospital personnel threaten discharge typically stating:  “You don’t fit ‘criteria’ for further acute care and will have to pay if you stay.”

As an advocate, if you feel your hospitalized loved one still has problems with mental status, mobility, pain, eating, or general well-being, here are suggestions for a safe discharge:

-tell hospital personnel you want to ”appeal” the discharge to Medicare and follow the process carefully reading the paperwork and making appropriate phone calls;

-contact the hospital ombudsman;

-screen and visit all recommended nursing homes prior to discharge;

-choose a worthy home health agency with any related therapy or IV costs delineated;

-make sure all necessary home medical equipment is delivered before discharge;

-assure new prescriptions have been filled;

-discuss these needs with the attending doctor.

Medicare patients have a right to be treated like human beings, not cattle.

Gene Uzawa Dorio, M.D.

1 Comment

  • John Stewart says:

    Just how do you “-choose a worthy home health agency with any related therapy or IV costs delineated; All you get from the hospital is a list of vendors. How can you screen nursing homes. Once again you only get a couple of places to choose from, and you are unable to get around, and in 2015 they sent me to the home via ambulance… Medical equipment is not delivered before you get home, and plans for bathing nurse, nurse, and physical therapy takes weeks. I discussed everything with the hospital doctor who informed me the Home care agency would do everything. Really? ? Without GWD I would still be waiting. When I was a volunteer ombudsman for Wise Senior Services there was supposed to be a large notice about how to contact the agency. I never saw one at HMNMH.

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