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Are they experiencing any memory loss?
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Mostly Independent
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I guess anyone can file an appeal doesn't mean they will win. If Medicare felt it was time for the person to be discharged then they get discharged. Looks like they were sending the patient to a hospital rehab so their care would be better than just going to a rehab.
As a case manager can u not contact Medicare directly and run it by them? You are asking layman here unless one our members has done ur job. I know we have some Social Workers.
I have found with some of our posters that they have no idea how Medicare works. Reason is they have never dealt with it. Also, regular insurance policies. Both have the right to stop care if they feel the person no long needs the care.
Generally, it's not medicare that "feels" anything. It's the facility. That's a common misconception when someone gets a notice. They think it's a medicare determination. It's not. Read it carefully. It's the facility determining that it's concerned that medicare may not pay. So it's being preemptive by getting rid of you.
When filing appeals, it's not until the third appeal that you get medicare's take on it. The first two appeals are with another private health care corporation. That third appeal is with a medicare employee or a judge.
JoAnn makes a very good point in the second paragraph of her response.
Someone in the hospital, at the managerial level, or in the legal counsel's office, should be advising you on this, b/c it could affect the hospital at many levels, and you certainly don't want to be responsible if the hospital isn't able to provide an answer.
In my opinion, this is a question that should be posed by a hospital manager (and that could be you) to either a higher level manager or directly to Medicare. The fact that you haven't gotten clarification (presumably in house/hospital) makes me think higher management isn't certain either.
I would ask legal counsel or a higher up administrator to raise this question directly with Medicare. Get yourself out of the decision making queue.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
As a case manager can u not contact Medicare directly and run it by them? You are asking layman here unless one our members has done ur job. I know we have some Social Workers.
I have found with some of our posters that they have no idea how Medicare works. Reason is they have never dealt with it. Also, regular insurance policies. Both have the right to stop care if they feel the person no long needs the care.
When filing appeals, it's not until the third appeal that you get medicare's take on it. The first two appeals are with another private health care corporation. That third appeal is with a medicare employee or a judge.
Someone in the hospital, at the managerial level, or in the legal counsel's office, should be advising you on this, b/c it could affect the hospital at many levels, and you certainly don't want to be responsible if the hospital isn't able to provide an answer.
In my opinion, this is a question that should be posed by a hospital manager (and that could be you) to either a higher level manager or directly to Medicare. The fact that you haven't gotten clarification (presumably in house/hospital) makes me think higher management isn't certain either.
I would ask legal counsel or a higher up administrator to raise this question directly with Medicare. Get yourself out of the decision making queue.
Is this a small hospital, in a small area?