In the preceding blogs titled Crash Course in Nursing Homes, Part 1, Part 2 and Part 3, I shared Susan's experiences with illegal nursing home practices and lessons learned. This post summarized the lessons learned for easy reference.
Lesson 1: Rehab/nursing home stays are only covered by Medicare if a patient is first admitted to a hospital for 3 midnights. You may think you're admitted to the hospital but you may actually only be on observation status. Observation status does not qualify you for medicare coverage for a skilled nursing facility. Ask your nurse, doctor, or the admissions team if you are "admitted" or on "observation status."
In Part 1, I shared Susan's story and reviewed Lessons 1-3. Susan was staying in a Skilled Nursing Facility (SNF) for rehab and was unsafe for discharge to home. The SNF threatened eviction once Susan's Medicare approved stay was completed. In Part 2, I shared the steps we took to fight Susan's illegal eviction and reviewed Lessons 4-8. Today's post will cover final lessons learned, including a resident's rights when transferred to the hospital.
Susan lived comfortably in the nursing home for several months under Medi-Cal custodial care payment when an illness required her to transfer to the hospital.
Lesson 9: Skilled Nursing Facilities are required to readmit residents within 30 days of transfer to the hospital and they are required to hold the resident's same bed if transferred to the hospital for less than 7 days. I was aware of these regulations already. We requested to sign a bed hold form at the facility. This bed hold meant that Susan's exact bed would be available to her for the next 7 days.
I can't count the number of times I've heard a patient say: "I didn't receive my lab results, and 'no news' is 'good news' so they must have been normal." Wrong. There are so many steps between ordering the labs and getting the results to you that results can go missing and important health information can be lost.
I became aware of this initially at my first job out of residency: I was covering for a colleague while he was out of town. I reviewed his patient's chart before seeing him and noticed that a skin cancer had been removed 6 months before. I walked in to see the patient for an unrelated problem, and, when examining him, I asked to see where his skin cancer was. He said, "I have skin cancer?" He had no idea since my colleague, for whatever reason, hadn't notified him. Because of this, I started a new process of notifying all of my patients of their results by mail. It was time intensive to print out all of these letters (usually every weekend), but I wanted to ensure that patients always received their lab results. I instructed them when ordering their labs (or procedure) that no news was NOT good news, and that they should call me for results if they hadn't heard anything in two weeks.