1 in 5 hospital patients need care after discharge, but can have limited choices unless they know their options, columnist advises

Health columnist Trudy Lieberman

"One in five patients across the country needs further care after discharge from a hospital," Rural Health News Service columnist Trudy Lieberman writes. "Many times their families don’t know where to turn for help." The hospital can be a weak link, she warns: "Discharge planning is deficient, can be harmful, and sometimes results in a patient’s decline."

Discharging hospitals can limit patients' options, Lieberman writes: "If hospitals are hitting the limits of what Medicare will pay for a patient’s care, they have a great incentive for moving people out. To them it doesn’t matter if a patient is moved to another state, as I was, or to another town. Either one can make it difficult for family to visit and keep an eye on the care, which is all-important."

Patients and their families may not be aware of just what sub-acute-care facilities, home-care agencies or rehabilitation centers can do, and may not even know about a relatively new type of hospital, the long-term acute care facility (LTAC), which "treats sicker patients for an average of at least 25 days for recovery," Lieberman writes. "Neither had I, when I found myself transferred to one early in 2018 after a long hospital stay."

Kentucky has one freestanding LTAC, Kindred Hospital in Louisville, and eight that are inside or adjacent to another hospital: in the Baptist Health hospitals in Corbin, Madisonville and Paducah; St. Joseph Hospital in Lexington; UK HealthCare in Lexington; St. Elizabeth Fort Thomas; a Kindred facility in Jewish Hospital in Louisville; and the Commonwealth Regional Specialty Hospital in The Medical Center at Bowling Green.

The 32-bed ContinueCARE facility in the 273-bed Corbin hospital recently won a Respiratory Center of Excellence designation from the Center for Improvement in Healthcare Quality, making it "the first facility in the country to receive this specific CIHQ designation for respiratory therapy," Baptist Health said in a news release.

Lieberman has suggestions for dealing with care after discharge: "Medicare requires a discharge notice, which sets out a patient’s appeal rights and procedures, to be given no later than two days after a person is admitted to a hospital. Some are given at admission, usually a time of confusion, and the explanation of rights is likely to be overlooked. Be aware of it, though, and read it carefully. You may need to rely on it if you think a relative needs to stay longer in the hospital. And for all families who need more care after a hospital stay, the website of the Center for Medicare Advocacy has loads of information."

For Lieberman's full column, and her previous columns, click here.