Monday, May 27, 2019

How to Fight a Nursing Home Discharge

Once a resident is settled in a nursing home, being told to leave can be very traumatic. Nursing homes are required to follow certain procedures before discharging a resident, but family members often accept the discharge without questioning it. Residents can fight back and challenge an unlawful discharge. 
According to federal law, a nursing home can discharge a resident only for the following reasons:
  • The resident's health has improved
  • The resident's needs cannot be met by the facility
  • The health and safety of other residents is endangered
  • The resident has not paid after receiving notice
  • The facility stops operating
Unfortunately, sometimes nursing homes want to get rid of a resident for another reason--perhaps the resident is difficult, the resident's family is difficult, or the resident is a Medicaid recipient. In such cases, the nursing home may not follow the proper procedure or it may attempt to "dump" the resident by transferring the resident to a hospital and then refusing to let the him or her back in.
If the nursing home transfers a resident to a hospital, state law may require that the nursing home hold the resident's bed for a certain number of days (usually about a week). Before transferring a resident, the facility must inform the resident about its bed-hold policy. If the resident pays privately, he or she may have to pay to hold the bed, but if the resident receives Medicaid, Medicaid will pay for the bed hold. In addition, if the resident is a Medicaid recipient the nursing home has to readmit the resident to the first available bed if the bed-hold period has passed.
In addition, a nursing home cannot discharge a resident without proper notice and planning. In general, the nursing home must provide written notice 30 days before discharge, though shorter notice is allowed in emergency situations. Even if a patient is sent to a hospital, the nursing home may still have to do proper discharge planning if it plans on not readmitting the resident. A discharge plan must ensure the resident has a safe place to go, preferably near family, and outline the care the resident will receive after discharge.
If the nursing home refuses to readmit a patient or insists on discharging a resident, residents can appeal or file a complaint with the state long-term care ombudsman. The resident should appeal as soon as possible after receiving a discharge notice or after being refused readmittance to the nursing home. You can also require the resident's doctor to sign off on the discharge. Contact your attorney to find out the best steps to take. 
For more on protecting the rights of nursing home residents, see the guide 20 Common Nursing Home Problems--and How to Resolve Them by Justice in Aging.

Contact us

Questions? Contact us at Elise Lampert, Attorney at Law
Elise Lampert, Attorney at Law
9595 Wilshire Boulevard | Suite 900 | Beverly Hills , CA 90212
Phone: 818-905-0601

Sunday, May 26, 2019

What's a Health Care Proxy and Why Do I Need One?

If you become incapacitated, who will make your medical decisions? A health care proxy allows you to appoint someone else to act as your agent for medical decisions. It will ensure that your medical treatment instructions are carried out, and it is especially important to have a health care proxy if you and your family may disagree about treatment. Without a health care proxy, your doctor may be required to provide you with medical treatment that you would have refused if you were able to do so.
In general, a health care proxy takes effect only when you require medical treatment and a physician determines that you are unable to communicate your wishes concerning treatment. How this works exactly can depend on the laws of the particular state and the terms of the health care proxy itself. If you later become able to express your own wishes, you will be listened to and the health care proxy will have no effect.
If you are interested in drawing up a health care proxy document, contact your attorney.


Contact us

Questions? Contact us at Elise Lampert, Attorney at Law
Elise Lampert, Attorney at Law
9595 Wilshire Boulevard | Suite 900 | Sherman Oaks , CA 90212
Phone: 818-905-0601

Tuesday, May 21, 2019

Medicare Beneficiaries Need to Know the Difference Between a Wellness Visit and a Physical

Medicare covers preventative care services, including an annual wellness visit. But confusing a wellness visit with a physical could be very costly. 
As part of the Affordable Care Act, Medicare beneficiaries receive a free annual wellness visit. At this visit, your doctor, nurse practitioner or physician assistant will generally do the following: 
  • Ask you to fill out a health risk assessment questionnaire 
  • Update your medical history and current prescriptions
  • Measure your height, weight, blood pressure and body mass index
  • Provide personalized health advice 
  • Create a screening schedule for the next 5 to 10 years
  • Screen for cognitive issues
You do not have to pay a deductible for this visit. You may also receive other free preventative services, such as a flu shot. 
The confusion arises when a Medicare beneficiary requests an "annual physical" instead of an "annual wellness visit." During a physical, a doctor may do other tests that are outside of an annual wellness visit, such as check vital signs, perform lung or abdominal exams, test your reflexes, or order urine and blood samples. These services are not offered for free and Medicare beneficiaries will have to pay co-pays and deductibles when they receive a physical. Kaiser Health News recently related the story of a Medicare recipient who had what she assumed was a free physical only to get a $400 bill from her doctor’s office.
Adding to the confusion is that when you first enroll, Medicare covers a "welcome to Medicare" visit with your doctor. To avoid co-pays and deductibles, you need to schedule it within the first 12 months of enrolling in Medicare Part B. The visit covers the same things as the annual wellness visit, but it also covers screenings and flu shots, a vision test, review of risk for depression, the option of creating advance directives, and a written plan, letting you know which screenings, shots, and other preventative services you should get. 
To avoid receiving a bill for an annual visit, when you contact your doctor's office to schedule the appointment, be sure to request an "annual wellness visit" instead of asking for a "physical." The difference in wording can save you hundreds of dollars. In addition, some Medicare Advantage plans offer a free annual physical, so check with your plan if you are enrolled in one before scheduling. 

Contact us

Questions? Contact us at Elise Lampert, Attorney at Law
Elise Lampert, Attorney at Law
95959 Wilshire Boulevard | Suite 900 | Beverly Hills, CA 90212
Email:elise@elampertlaw.com
Phone: 818-905-0601