Leslie Newlife

Senior care and the need for a private-pay, or hospital advocate

advocate

 

Senior care, particularly for a loved one in the hospital, can be times of high stress on many fronts. Most often, the hospital stay can begin fairly smoothly. You’re happy with the staff, and are even more at ease because you were able to catch the doctor on his rounds to the latest updates. But then you realize that maybe the nursing staff didn’t get the updates you’re doctor told you. As your frustration ramps up, you realize it’s time talk to someone you can rely on for getting the right answers. As such, your options include a couple of ways to proceed to find a representative who can be an advocate for you and your loved one.
 
Should you use the hospital’s ‘Patient Advocate’?
 
It might not seem like the best way to go, after all you’re looking for a quasi-independent representative…not someone on the hospital’s payroll. Generally though, these staffers are trained and members of the American Hospital Association.
 
Using a ‘private-pay’ advocate.
 
This choice will cost you for the service, but you’re likely to receive someone with a lot of experience in areas like:
 
* Medical Assistance: familiar with diagnosis and treatment options
 
* Insurance Assistance: knows the ins-and-outs of the paper chase with insurance companies; there to fight claim issues.
 
* Elder/Geriatric Assistance: a lot of expertise in Medicare and hospice services.
 
* Legal help: provides oversight on medical errors that may be occurring.

 

Overall, the paid advocate can be a welcomed ‘third party’ to not only provide patient advocacy, but help track all the medical bills.

 
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Nursing home(s) for short term stays possibly avoidable if a ‘Swing Bed’ is available at your hospital

You’ve just logged three, consecutive days of acute care in your hometown, rural hospital. Fortunately, ‘Medicare Part A’, will be picking up a good portion of that huge medical bill

Still, you’re thinking about the next step: perhaps a short recoup time in a Skilled Nursing Facility(SNF). The difficulty for you is that the only nursing home(s) is over a hundred miles from your home.

But, then, you hear the hospital’s discharge planner say the ‘swing bed’ word, and you liked the part about not having to travel up river to the nursing home.

HOW DOES IT WORK?

Some of the requirements your rural hospital must meet are outlined by the Centers for Medicare and Medicaid Services (CMS) and include:

—(location) in a rural area, which includes all areas that are not delineated as urbanized by the U.S. Census Bureau based on the most recent census for which data is published (an urbanized area does not include an urban cluster);

—Have fewer than 100 beds (excluding beds for newborns and intensive care-type units);

By law, certain rural hospitals have ‘swing bed’ arrangements through Medicare Part A and the CMS.

After the hospital assesses your healthcare needs, you’ll be told if you can use one of the hospital’s swing beds. In effect, you’d be moving from an acute level of care to skilled rehabilitation. All this without leaving your current hometown hospital.

I’M IN A CITY HOSPITAL. CAN I GET A SWING BED AT MY RURAL HOSPITAL?

An SNF patient doesn’t really have to be from the same hospital—or Critical Access Hospital— for a swing bed assignment in your hometown, rural hospital. The hospital is required to make that available. Your hospital’s discharge planner can help you plan that next step.