From Hospital to Nursing Home and Back

advance directive health care proxy long term care power of attorney medicaid medicareNo one wants to go to a nursing home. But it’s unavoidable when patients get caught between hospital policies that require earlier and earlier discharge on the one hand, and the inability of family members to care for elderly or otherwise fragile patients who are being released from hospital care too soon for home care to suffice. So it’s particularly common for older patients who’ve had surgery or suffered serious illness to be sent from the hospital to a nursing home to recover. According to a June 13 NPR “Shots” Health News report by Jordan Rau, “Medicare Takes Aim At Boomerang Hospitalizations Of Nursing Home Patients,” this practice is creating a growing problem for patients who don’t receive adequate care at the nursing home and wind up back in the hospital within days, sometimes dying as a result of complications that could have been avoided. The problem isn’t just that hospitals push patients out their doors earlier, but that “many [nursing] homes, with their sometimes-skeletal medical staffing, often fail to handle post-hospital complications — or create new problems by not heeding or receiving accurate hospital and physician instructions.” The variable that makes a difference in the outcome is the quality of the nursing home to which the patient is sent. “Out of the nation’s 15,630 nursing homes, one-fifth send 25 percent or more of their patients back to the hospital, according to a Kaiser Health News analysis of data on Medicare’s Nursing Home Compare website. On the other end of the spectrum, the fifth of homes with the lowest readmission rates return fewer than 17 percent of residents to the hospital.”

power of attorney long term care planning medicaid medicare nursing home While the problem reported at NPR happens most frequently to Medicare patients, you can take steps now, while you are healthy – no matter what type of medical coverage you have — to protect yourself from the risks of post-hospitalization nursing home care. You can look into the quality of rehab centers or nursing homes in your area, and have  an attorney write a health care proxy for you in which you stipulate which of them you wish to use if you ever need one. This would be particularly important in the event that you were discharged from the hospital while still unable to articulate your preferences at the time. You can also use estate planning documents to establish a fund that sets aside money that can be used to provide you with the best nursing home care possible in the event you need it, including paying for a higher-quality care facility. These are part of the services available to people who establish will and/or trust documents, which take care of planning far more than which niece or nephew gets your cherished marble chess set or your grandmother’s silverware.

Contact me today for more information on how you can protect your own health and well-being by planning your will and estate documents now.