Building Legacies that Last Estate Planning and Elder Law

Hospital Discharge Planning

Bigstock-Doctor-with-female-patient-21258332[1]Before a Medicare patient can be discharged from the hospital, there must be a plan in place for any needed continual care. Patients and their families should double check some information in that plan.

When Medicare patients are ready to leave a hospital after an extended stay, they often are not ready to go home and resume their normal lives. They might need to be transferred to another facility, such as a nursing home or a rehabilitation center. It depends on the needs of the specific patient being discharged.

Medicare requires that a plan for care be developed with a social worker who can help the patient understand the plan. Just taking the word of the social worker about what options are available, is not always advisable as the Pittsburgh Post-Gazette points out in "Doublecheck when they say the rehab center doesn't have room."

Patients are sometimes told that their preferred facilities for care after being discharged from the hospital do not have room for them. Sometimes that is true, but it is not always true.

Hospitals that have financial interests in other facilities, all too often try to steer patients into those facilities and away from others. For that reason, it is a good idea for patients and families to call facilities for themselves to ask about availability.

If you think a hospital is not doing what Medicare requires it to do, then it is a good idea to contact an elder law attorney.

Reference: Pittsburgh Post-Gazette (Feb. 26, 2018) "Doublecheck when they say the rehab center doesn't have room."


Entitlement Reform Might Be Next

It is looking increasingly likely that next year Congress will take up reform to entitlement programs. Bigstock-Elder-Couple-With-Bills-3557267[1]

The U.S. has some political junkies who follow everything that goes on in Washington D.C. all the time. However, for the vast majority of Americans, politics is preferably just done every four years.

Presidential elections are held, a winner is declared, and most Americans go on with their lives not thinking too much about politics.

Things are different now. None of us can escape political talk. It is everywhere.

Many people would probably appreciate a break next year, until October before the mid-term election campaigns heat up.

But it appears that Republicans may propose cuts to some of the most popular government programs, according to Financial Advisor in "GOP Laying Groundwork To Cut Future Social Security, Medicare, Welfare Outlays."

Republicans are talking about making cuts to programs for the elderly, such as Social Security and Medicare. It is likely that any proposed cuts would be delayed and not effect current retirees.  However, they will still be controversial for Americans who plan to rely on the programs in the future.

Cutting Social Security and Medicare is considered to be like touching the third rail in American politics. These are not popular proposals. Going through with this plan, guarantees that we will not be getting a relief from politics in 2018.

Reference: Financial Advisor (Dec. 6, 2017) "GOP Laying Groundwork To Cut Future Social Security, Medicare, Welfare Outlays."


Being Under Observation in the Hospital

Bigstock-Doctor-with-female-patient-21258332[1]Many elderly people face gigantic medical bills for hospital stays because of how they are classified by the hospital. This makes a big difference in how much Medicare will pay.

When an elderly person has an extended stay in the hospital, they are almost always under the impression that Medicare will cover most of the costs. However, many stay in the hospital for weeks and only later discover that they are responsible for most of the costs of their stay.

This is because Medicare is very particular about when it will pay for hospital costs.

For Medicare to pick up the bill, the patient must be classified as an inpatient. This means that the patient has been formally admitted to the hospital.

If the patient is an outpatient, Medicare will not pay and those patients who are in the hospital "under observation" are still considered to be outpatients, no matter how long they are actually in the hospital.

The story is picked up by The New York Times in "Under 'Observation' Some Hospital Patients Face Big Bills."

Elder law advocates have long pointed out that the rule is absurd.

The patient does not always get to choose what the hospital writes down in the file. The patient also does not always know the importance of being formally admitted, instead of just being under observation.

There has never been a way for the patients to challenge their designations later, until now.

A judge in Connecticut has recently opened the door for legal challenges.

Reference: New York Times (Sep. 1, 2017) "Under 'Observation' Some Hospital Patients Face Big Bills."