Can a nursing home discharge a patient knowing they need full-time care?

If you feel that the patient needs to be in nursing home care and that they are unfairly trying to discharge him or her, try your local long-term care ombudsman and get some advice. You can find the contact for this person on your state website or at www.ltcombudsman.org. You type in the Zip code of the home. This person is your representative. Good luck,
Carol

There seems to be some confusion on how and what medicare will pay. It is true medicare recipients receive 100 days of skilled care coverage per "spell of illness". It is also a fact that medicare will pay 100% for the first 20 days. However, from day 21 to day 100 (or whenever in between the resident no longer requires what Medicare deems as skilled nursing care) the resident is responsible for what medicare calls co-insurance which is around $140.00/day or $4200.00/month. In most cases this is covered by Insurance such as AARP, United, etc. or by the Medicaid program. This is not a policy written by the nursing home it is the policy of the federal government. Therapy will continue for the total 100 days if the therapist can document progress and can continue after the original 100 Medicare days under Medicare Part B. In this case the residents stay is no longer being paid by Medicare, but ongoing therapy is paid at 80% by Medicare and 20% by the the resident. All other charges such as Room/Board, Medications, etc are paid privately, by insurance coverage or by a combination of both. Of course most are paid under the Medicaid program if the resident meets the financial requirements. It might sound confusing, but I hope this answers some questions.

By the way, the Federal Regulation covering Admission, Discharge, and Transfer in a Nursing Home is I believe F-483. Might help to make yourself familiar with this to assure the nursing home in in compliance.

Federal regulations for discharging of nursing home residents limits the nursing home from discharging a resident without a specified reason and advanced notice, unless the resident is a danger to themselves or others. They must assist you in finding an alternative that is safe and will provide the level of care the resident requires, they must provide you with a minimum of 30 days notice of intent to discharge (unless they are a danger to themselves or others) and they must provide you with a copy of their Discharge Policy.

The three main reasons for a resident to be discharged from a nursing home are: 1. Unpaid bill. 2. Involuntary Psychiatric Reasons. 3. Medicare benefit has been exhausted and the facility has no Medicaid bed available. 1 and 3 both require a 30 day notice and assistance in finding safe placement. The nursing home must assure the resident being discharged will be safe and the care required will be provided. 2 is usually an emergency discharge to a psychiatric unit for uncontrollable behaviors (normally). In this case the nursing home still must provide a copy of their discharge policy at the time of discharge.

I would urge you to follow Carol's recommendation and contact your local Ombudsman. They may not be able to prevent the discharge, but they will make sure the discharge falls within the Federal guidelines and that the nursing home provides the assistance you need to find a safe environment for your loved one and they will most likely add another 30 - 60 days related to their investigation. Good Luck!!! Hope All Goes Well and let us know the outcome.

Sadly, Diana, it's not the principle of the thing, it's the money. The nursing home has ways to rid itself of residents who can't pay $3-8,000 a month for their room, board and care. They won't exercise those options until they've sucked every penny they can reach out of the pockets of the resident and any relatives willing to open their pockets to the nursing home. The easy route for you is to take care of your money first. If you decide to take the high road and take responsibility for the well-being of your disabled relative, you can either spend a lot of effort or a lot of money. I chose to expend the effort, and by doing it lovingly, I've reaped a tremendous reward in love and gratitude. I've also made some enemies in the elder care field. You've got some tough choices ahead. Choose carefully. Good Luck. God Bless You.

My husband was discharged from one nursing home much too early often from rehab they did me a favor when they refused him adm on time from the hospital because they said his IV meds were too expensive so I started using another NH which was glad to get our 100 days of full coverage because we had great insurance

I dont understand. medicare has a 100 day running period. 5 1/2 months later they are making me pay because the 100 days since 9/11/11 when she fractured her hip and in and out of hospital for UTI's, pneumonia, sepsis, you name it since from SNF I couldnt get her home....at least thats what they made me think. Now I am paying out of pocket because the 100 days ran out for physical therapy. She now has so many other problems. Should I challenge it. I am billed for over 8000.00 for this month alone for Room and board plus meds.

I certainly would challange the money they are charging with medicare the first 20 days are coverd fully the last 80 are covered for 80% and beds in rehab or NH are at least 450 dollars a day-I would make up a payment plan to pay what you can a month or they can taje you to court that will cost then big bucks so they may go along with the payment plan. In our state PT continues until inprovement stops or they reach a platue to what the person was before-there is some fudging there some people get more benefits than other it really depends on who runs the department.