Should a patient be walking before leaving the hospital?

For hospitals and hospitalizations it is still all about DRGs which is what the coding is on each admission.
So say you come in with pneumonia. DRG will be, for instance, 2 days. They expect you out on day 2. If so the hospital breaks kind of even, does OK. If you are out in ONE day and then get pills, no IV and are home, hospital WINS and gets GOOD pay. If you are there for 5 days the hospital is a big loser.
You are coded at once. This man is in ICU with blood clot; he will have quite a number of days as will need perhaps surgery perhaps clot buster, perhaps IV blood thinners. So maybe 3 or 4 days. Hospital is a winner if they can get him out in that time. And a BIG WINNER if they can get him out earlier. And a loser if he is in for 8 days. See what I mean. That is MEDICARE payment and nothing really to do with insurance or advantage plans. They will charge you something for every day in but they don't depend on getting you out early. Only the hospital does.

Works much differently than MD office visits and etc.
Look up "What are DRGs" and look up "How do hospital DRGs work."
This basic from the internet:
"When you've been admitted as an inpatient to a hospital, that hospital assigns a DRG when you're discharged, basing it on the diagnosis you received and the treatment that you needed during your hospital stay. The hospital gets paid a fixed amount for that DRG, regardless of how much money it spent treating you."

This is the short and sweet about why the hospital wants you OUT fast.
So tell them you know all about DRGs and you know an "unsafe discharge and will inform JCAHO about it" and they will start shaking in their white shoes.

BetsySue; I sure hope that your DH is doing better. Please let us know.

And yes, I've been through this recently, so feel free to ask.

This question is from DECEMBER 2023

Just want want to say something about Medicare Advantages. They are contracted by Medicare and must follow the rules for parts A & B. I would call Medicare and ask if there is anything they can do. My daughter wasca Unit manager and fought with them all the time concerning things they must cover under A&B.

If this is not an employer based insurance, I would consider getting on traditional Medicare withva supplemental. Your Office of Aging can help you.

Time to contact Social Services.
To go home prior to being able to walk would be an unsafe discharge.
You may or may not need rehab transfer for a week or so, but you will certainly need some inhome care.

As BarbBrooklyn whose husband was recently in ICU can tell you, they come at you about discharge before they even see a patient come out of coma these days.
You should demand to speak to discharge planning and social services AT ONCE and tell them that you will not accept your husband returning home as an "unsafe discharge". Stress those words exactly as unsafe discharge is reportable to JCAHO and can lose a hospital its licensure.

I wish you good luck.
I hope Barb is around to talk with you; consider shooting her a private message if she doesn't pick up on this thread. She recently went through all of this.

Hope you will continue to update us and am wishing you good luck. You are going likely to need instruction on blood thinners, etc. and some patients return home with family responsible for lovenox injections and etc. This is all important stuff.

Sorry, cannot keep up.
The OP has already started a new thread, same topic.
WHY?

"Should a patient be walking before leaving the hospital?"
"Walking before leaving hospital Asked 6 min ago by Betsysue2002

Was he walking before he fell ill?

So your husband is one for whom the clotting problems happened secondarily to covid? That is one of the most dangerous problems they are seeing with covid. Are you suggesting that they have removed a "huge clot" as you say, and then, without progressing to a step-down unit he will be sent directly home, just discharged just like that?
How many days has he been in ICU?
Is he still testing positive for Covid?
What blood thinners have they put him on and what followup will he have?
How old is he?
What is his overall condition? That is to say does he have a history of clotting problems, heart problems, lung problems?
Do they even know if he CAN walk?
And are they WISHING him to walk for clot prevention?

I can't know your husband's condition at all. I can only say as an old retired RN that this wouldn't have happened in "my day". Cardiac stepdown was where I worked. There was no case EVER that I saw that went home from CCU or ICU without stepdown care.
I would be scared to death if I were you.
I honestly cannot assess what is happening here, or has happened; what you tell us is just to little to go on, but the removal of this clot does not sound good to me.

I wish you the very best. As I said, I would be scared. What, honestly, are they even wanting you to watch for, assess him for, act on "if"???
This seems pretty outrageous to me.

Should be walking.
No fever present.
Proper home care or rehab planned.

No unsafe discharges on my watch!

Unsafe discharge. Use those words and good luck

Either Placed in a rehab or Physical therapy coming into the home and a VNA Nurse and CNA which the doctor at Hospital can order and is covered by medicare .

Betty Sue, welcome.

We want to teach you a phrase. It's "unsafe discharge".

Your husband should be discharged not to your home, but to a rehab facility.

I’m sorry to hear about your husband falling. Have you spoken with his doctor about him entering rehab to gain strength and balance? Has the doctor ordered home health for him?