Rochester Senior AdvisorWhat should I do first when a Rochester hospital says my parent is ready for discharge?
Ask to meet the hospital's discharge planner or case manager, find out whether your parent was formally admitted or held under observation, and ask for the written discharge plan and the list of post-acute options before agreeing to anything.
Admission status decides whether Medicare will pay for a nursing home rehab stay, which requires a three-day inpatient admission. Observation days do not count. The four largest hospitals in the area, Strong Memorial and Highland (UR Medicine) and Rochester General and Unity (Rochester Regional Health), all have case management teams who handle this daily.
Does my parent have to go to the nursing home the hospital suggests?
No; the hospital must give you a list of Medicare-certified options and may not choose for you, and you can ask for the CMS ratings, staffing and inspection results of each before deciding.
Our nursing home directory lists every certified home in the five counties with CMS's figures. Distance matters: a home your family can visit daily often produces a better recovery than a higher-rated one an hour away.
What are the options besides a nursing home after a hospital stay?
Depending on needs, a parent may go home with Medicare home health visits, move to an assisted living residence that can meet their needs, enter an Assisted Living Program bed if they qualify for nursing home care and Medicaid, or go to short-term rehab first.
An assisted living residence must complete its own assessment and receive a recent medical evaluation before admission, which can take a few days. If that path is likely, start calling residences before the discharge date is set.
What if I think the discharge is too soon?
A Medicare patient who disagrees with a hospital discharge can ask for a fast appeal through the Quality Improvement Organization named on the Important Message from Medicare notice, and the hospital cannot discharge while the appeal is pending if it is filed on time.
Read the notice carefully; the deadline is usually midnight of the planned discharge day. For nursing home discharges later, New York's Nursing Home Complaint and Discharge Appeal Hotline is 1-888-201-4563.
Who can help us plan the next step for free?
NY Connects at (585) 325-2800 for Monroe County, the county Office for the Aging elsewhere, the hospital's case managers, and a senior advisor can all help at no cost to the family.
Bring a list of medications, the parent's insurance cards and any powers of attorney or health care proxy to every conversation. Decisions move faster when those are ready.
At a glance
| At discharge you can | At discharge you cannot be made to | |
|---|---|---|
| Choose | Pick from the list of certified options | Accept the first bed offered |
| Appeal | Ask Medicare's QIO for a fast review | Leave before the appeal is decided, if filed on time |
| Plan | Ask for the written discharge plan | Decide without seeing it |
Sources include the N.Y. Social Services Law and Public Health Law, 18 NYCRR Parts 487-494, 10 NYCRR Parts 415 and 1001, Department of Health GIS messages, CMS, the VA and CareScout, as cited above; see our editorial standards.
