Appealing a doctor's decision to discharge. Any advice?

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Has anyone had any experience with appealing to Medicare under the provision allowing such an appeal when the patient or authorized party disagrees with a doctor's decision to discharge?

The PCP has decided to discharge my father tomorrow even though he (a) can't stand (b) has heart rate, BP, and SAT rate that are higher than normal, (c) lives alone (d) won't get any home care until the day following discharge?

I intend to call the Medicare specified contractor tomorrow to appeal the decision, but honestly expect a runaround or support of the doctor's irresponsible decision.

Anyone have any experience with this short term rapid appeal process?

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simple. It's an unsafe discharge. Walk away. Will have to involve social then. Sounds harsh but it's our life too and soooo hard watching them . We shouldn't be in this position.
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Helpmequick21 - I totally understand what you're going through - I've been in that situation for 2+ years. My 95-year old Mom lived with me, fell and broke her hip and wrist, and her life descended into H*ll on earth... She was very bright when she fell, although at 95 she was having some minor memory issues, but some of her docs ("primary care") simply put the label senile dementia front and center on her chart, and treated her accordingly (I actually fired a few docs along the way). I was pushy, stubborn, and vocal enough that my Mom has, in fact, received advanced medical care despite her age (she's now 97!) Mom has had serious vascular (circulation) problems for years, and of course, has really skin... She had developed a huge ulcer on top of her foot following damage caused by one of the "skilled nursing" facilities. The original "options" given were for amputation - which she refused - or "palliative/hospice" care. Bless her Vascular Surgeon, who called the next day, asked about her heart and lungs (good), and said he doesn't believe in limiting health care, options, or treatments just because of someone's age, and thought we should try a bypass below her knee... At 96, she made it through a 5 1/2 hour bypass surgery,  although afterwards she was in ICU for 14 days (on a ventilator for 3).  The surgery successfully established circulation and healing of her foot! Sadly, like your Mom, she too was very bright when she was originally injured by a fall at 95, and since then has declined - again, as with your Mom, following several surgeries, anesthesia, extended Percocet use, and just plain shock... Now 97 years old, she's still cognizant most of the time, but lately has been getting confused and her short-term memory has declined... She is, though, receiving Occupational Therapy and Physical Therapy (each 1/x per week) from an outside facility, is improving, and can now get up from a wheelchair to a walker and walk for quite a distance. (Again, though, I had to be very "persuasive" to get therapy approved since she's in a nursing home...!) I hope your Mom improves, and keep advocating for her, although I really understand how frustrating and exhausting that can be... Good luck and bless you for caring!
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By the way they gave us the right to appeal decision paper after she was discharged and out of the hospital as we were walking out which makes a pretty difficult at that point because you don't even have a chance to look at the papers. If I seem better it's because I am because I've screamed and yelled for the last three years trying to be her biggest Advocate because every health professional I talked to told me you had to be with the elderly sick to say this but once again they don't care about the elderly everything is dementia even if they were okay when you brought them there they come out worse than they went in it's been my experience all the time
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I have this experience on there every time my mother is in the hospital they discharged your parent I don't know how old they are because they are elderly because they are elderly and they put them in for observation because they didn't do any revelin testing I was told that's all Insurance allows my mother quite recently possibly had a TI a will we know that she did but because the doctor didn't see fit to do imaging and MRI and he put her in under observation he told me yes she probably had a t i a but she's better now and a holler testifying bottom line to health care in this country for the elderly is non-existent my mother has two insurances the second one is very good they don't want to take care of the elderly they want to ask you what the abased line is whether or wether not they have dementia and they just want to tell you it's dementia nine times out of ten as far as my mother is concerned it has been from withdrawal of meds that they took her off even though I gave them the list and told them she could not come off cuz she could die changed her meds which disagreed with her I had a mother who was 100% continent she came home from the hospital she was getting worse every day they would changing her meds incontinent and then she had a t i a and also impacted so that's the experiences I've had from hospitals and I don't know whatever else any of us can do to change it the only thing is if you have your own money and a pretty well-off you can pay for private care you can pay for a week and respite so you can get a break but other than that doctors do not will not do much more for your parent if they seem to be better that's it
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Just a note per some of the answers/information given here (i.e., for example about 5 steps? Case manager/judge, etc.?) Unless it differs from state to state, all that is necessary is that you call the medicare number on the form that should be given to you with the info about the planned discharge and say you want to challenge the discharge. (You can also tell the "case manager", or social services people you're probably dealing with, but in my case that was just a "you need to know I have appealed the discharge with Medicare" (there is a specific company that usually handles this, but it is under Medicare's direction and that is the number given to call...). I didn't ask permission - or discuss the situation with any hospital personnel or doctors - just called the Medicare appeals phone number. If the hospital or facility attempting the discharge doesn't automatically provide you with the official information re Medicare appeals and the process, ASK for it! You should actually have to sign acknowledgment of having received it! I appealed on 3 different occasions, and my appeal was upheld on 2. The third was denied, but that still gave me the extra two days I felt my Mom needed to safely (mentally and physically) move to a different facility. The only time you have to pay everything out of pocket is IF Medicare denies the appeal and you fail to comply with the discharge at that point... Even then, you have until noon on the day following Medicare's decision to have the patient moved. Knowledge gives you the strength to stand up to the bureaucracy and system that are only thinking in terms of $$$'s and not in the best interests of your loved ones. 
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I'm late to the party to thank you Garde Artist so thank you for your comment.
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I already answered this so I deleted my comments.  2 months ago.
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Yes you have a right to appeal a discharge with Medicare ,,their are actually 5 steps to,a appeal ...first the appeal when you tell the case manger you want to appeal the discharge , then you can also reappeal by calling and talking to them , the next step goes to a judge to decide ,, I don't know the last 2 steps ...
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I know this question was posed 2 years ago, but if anyone is still reading the answers this could help them... I absolutely do know about the right to appeal a "planned" discharge deemed by family (POA, etc.) as premature or unsafe. Also, it seems there is some confusion about the Medicare "100 days" rule... My Mom, 95 at the time, fell & broke her hip and wrist. She had successful surgery, but was injured (her feet, another story!) by the first "rehab/skilled nursing" facility she went to from the hospital. Within one week, (with POA and Medical POA) I jerked her out of that abusive situation and had her transferred to a different facility. They were caring, competent, but the damage to my Mom's feet was so severe she required wound care and dressings every other day, and was on narcotic pain meds for a long time. She was seriously hurt and mentally confused from the trauma of her medical situation and Percocet every 4 hours. Mom had never signed up for Medicare Part B when she retired in the 60's (this IS an option, although at the time of Mom's retirement it was not explained and she didn't realize the ultimate implications). Medicare Part A, which provides coverage without cost for anyone who paid into Social Security, kicks in for in-hospital care and skilled nursing/rehab following discharge from the hospital. The MAXIMUM Part A coverage is 100 days post-hospital. The length of coverage is determined by measurable medical and/or rehab progress. The first 20 days are covered at 100%, but the potential 80 days remaining require a copay (2 years ago Mom's was $157.00/day). (A lot of money, but far less than the cost without Medicare for the same services/facilities.) Mom did have good private insurance, but because she didn't have M. Part B, this is where her situation got dire... She had to pay co-pays, MediVans for doctors' appointments (BTW, these are NOT covered for anyone by insurance), many costs that would have been covered by "Primary - Part B - coverage". Everything was out of pocket, and her compulsively hoarded savings were quickly dwindling. (She was a survivor of the "Great Depression" and was terrified of not having a nest egg to fall back on. She deprived herself of many pleasures in life to save-save-save!) Now, so much for that! The facility (social services office) dictated a planned discharge date early on in her stay (20-30 days?), citing as a reason that she wasn't making measurable progress in physical therapy. I'd heard that same day from one of her therapists that she was doing well, and challenged the discharge. You should be provided a page explaining patients' rights to appeal with Medicare, and I was required to sign an understanding of the discharge and options. I DID appeal! A simple phone call to the number listed kicked the appeal into place, and automatically guaranteed at least a 24-hour stay on the discharge. A review was then conducted by Medicare medical experts of her entire medical file and current conditions. They provide a decision within 24-48 hours, with costs remaining covered, until their decision to agree with the facility's discharge plan or their denial. Mom's appeal was approved, with Medicare agreeing with me that it was premature to discharge her. From that point, she had to be periodically evaluated for discharge eligibility, and each time they set a new date the same option to appeal existed. I made several more appeals, which were upheld, until she had used approximately 85 of her 100 days of coverage... She was then moved down to a lesser level of care section in the facility, and all costs (about $8,000/month) were payable from her pocket... Her orthopedic doc stated that he believed with rehab she could regain the level of mobility she had before her fall, and ordered she receive that rehab... That entailed moving her back to the higher-level of skilled nursing/rehab, and also kicked Medicare Part A coverage back in play... Finally, without about 94 days of the 100 used, she was deemed able to move to assisted living (with a LOT of help!), and was discharged to an AL location I chose... She had an acute medical condition arise after about 3 weeks there, returned to the hospital (covered by Part A),
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Yes, but I didn't have to contact Medicare - I simply refused to allow my father to be discharged before he felt he was ready.

The doctor came in and pretty much said, what the heck?! I said, my father does not feel he is ready to go home. Now the doctor spoke with my dad and asked him why. My dad was allowed to stay the extra day and then he decided he was ready and was discharged.

Patients have rights and there are people within the hospital you can contact for just this scenario. Patient Advocates.
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