March 2011, Volume 14, Number 1
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Discharge Planning to Obtain Favorable Outcomes for Elderly Patients
All too often, hospital discharge planners come across elderly patients who have regained medical stability, but not the ability to care for themselves at home. Faced with this dilemma, discharge planners must look outside the hospital to obtain suitable and affordable care for the patient. And because of limited hospital space and expensive costs, time is always of the essence for discharge planners developing such a plan.
This already complicated scenario becomes even more difficult when patients have neither powers of attorney nor family members who wish to be involved. Particularly with patients who have limited mental capacity, discharge planners may really be challenged to find a workable solution without seeking outside assistance. For instance, facilities want assurance of payment before they accept new patients, and discharge planners may be unable to provide this assurance without first obtaining certain financial information. Fortunately, discharge planners can seek solutions from Elder Law attorneys, Ombudsmen, and fiduciaries.
While hospital discharge planners are often presented with highly complex situations in which they are forced to act quickly, they may be entirely unable to proceed without first seeking legal counsel or fiduciary services for the patient. Through this collaboration, however, discharge planners can create individualized plans for even the toughest of cases. For instance, hospital discharge planners regularly reach out to JacksonWhite for a variety of useful tools, such as:
• Free ALTCS guides to provide patients and their families with comprehensive information about public benefit programs.
• Free Prescreening to help discharge planners come up with viable care options.
• A decision-making matrix for determining who can act as surrogate for patients.
• Free power of attorney forms so patients can appoint an agent to act on their behalf without paying costly attorney fees.
The following examples better illustrate precisely how a group process is useful, if not necessary, for discharge planners:
1. Mr. S
Mr. S was admitted to the hospital after the police found him eating hollyhocks in his front yard. Mr. S did not have any powers of attorney, nor did he have family members or friends who were willing to help. After a week in the hospital, he began clearing up, although the early signs of dementia were definitely present. He told the discharge planner about an account somewhere in Wickenburg, and that he wanted help. Although he was ready to be discharged to a nursing home, the facility refused to accept Mr. S without a guarantee of payment. The discharge planner was faced with locating his bank account, but Mr. S did not remember the bank’s name, nor did he have the capacity to make the calls himself. Before moving forward, the discharge planner had to determine who would go to Wickenburg to investigate, who would pay the facility, and who would help Mr. S move. The discharge planner’s only option here was to obtain the services of a fiduciary or geriatric care manager who could do the necessary legwork to get Mr. S out of the hospital and into an appropriate facility. Referring Mr. S to legal counsel was not only appropriate for the discharge planner, but a necessity for Mr. S.
2. Mrs. I
Mrs. I was hospitalized due to a stroke, and she lost the ability to communicate. She does not have a power of attorney, and her only family lives in Alaska and does not wish to be involved. She was ready to be discharged to rehab, but the skilled nursing facility would not take her without knowing who would cover copays and help her obtain long-term care coverage if necessary. The discharge planner needed to know whether ALTCS was appropriate, and, if so, who would apply for the benefit on Mrs. I’s behalf. The discharge planner referred the case to an Elder Law firm that helped Mrs. I obtain benefits. An attorney handled the financial portion of Mrs. I’s ALTCS application, while the facility and the hospital managed her care. After all, hospitals are not charged with overseeing patient’s finances; their job is to treat patients medically and get them out of the hospital.
If hospital discharge planners could not seek outside professional help, patients such as Mr. S and Mrs. I would be severely disadvantaged. Of course, this group process would not be necessary if everybody planned ahead, had enough money to pay privately for long-term health care, and had somebody lined up to handle their affairs. But, as the above cases demonstrate, the reality is that many patients require additional support to obtain suitable and appropriate care. Sadly, many elderly patients are quite alone, and depend heavily on this process to obtain the favorable outcome they require and deserve.
FREE ALTCS Trainings for Health Care Professionals
There is always new information and things to learn about ALTCS eligibility. Make sure your up-to-date by attending one of JacksonWhite’s free trainings for health care professionals. Seats for all free health care professional trainings are limited. Please visit this page for a list of training dates and to RSVP.
2011 ALTCS Eligibility Numbers
$2,022 – Monthly Income Limit for an Individual
$2,000 – Resource Limit for an Individual
$101.10 – Personal Needs Allowance
$109,560 – Maximum Community Spouse Resource Deduction
$21, 912 – Minimum Community Spouse Resource Deduction
$1,822 – Minimum Monthly Maintenance Needs Allowance
For an explanation of these numbers, request an ALTCS Rate Card here.
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