Hospital Stays – Know Your Rights

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CARA executive director Jodi Reid addresses a workshop for retirees at the Redding Library on April 12 regarding patient rights during hospital stays.

Are you facing an upcoming hospital stay? Premature discharge is a huge problem, and a bit of advanced planning can make a world of difference when it is time for you to return home.

The California Association of Retired Americans (CARA) had much to say in their recent special workshop. The big overall? Record this telephone number:

Livanta – California Medicare Appeals Helpline: 1-877-588-1123

You can receive assistance to appeal a discharge from a hospital, skilled nursing facility, home health agency or comprehensive outpatient rehabilitation facility. You can also file complaints regarding the quality of Medicare-covered services.

Livanta is your national advocate if you feel you are being discharged prematurely from a hospital. Making the call will start your file and stop your discharge until it is cleared up by the hospital staff and a Livanta representative.

PLAN AHEAD

I. Hospital stays for surgeries etc.
Get detailed info ASAP and as much as possible from a health care provider before you are admitted, and about what is involved post-visit. Most people still don’t do this for themselves or loved ones and it leads to problems like living conditions in recovery and with accessibility/mobility. Hospitals aren’t good at communicating this to patients, or don’t have enough staff to do it properly.
  • Have a family member/friend record any conversations about your care pre- and post-visit with a smartphone device etc.
II. Discharge
Hospitals are notoriously understaffed on weekends. They are required to have a discharge planner coordinate a safe discharge for you either through a social worker, nurse, or the hospital discharge planner. The problem is most hospitals discharge patients too quickly and try to do it on Fridays to reduce bed counts. You may end up back in the hospital because of this. Hospitals can be fined up to $10,000 if a patient re-enters the hospital within 30 days of an unsafe discharge.
This behavior is so pervasive that Medicare now contracts with a third party (Livanta) to make sure you have a safe discharge. Medicare pays for you to appeal your discharge. This is a secret hospitals don’t want you to know about.
Should you end up at a skilled nursing facility for recovery, Medicare pays in full for the first 100 days. Medicare also pays for hospice services.
III. Make sure you are fully “admitted” into the hospital- not held for “observation”
Observation is a way hospitals attempt to get around not having to pay the possible $10,000 fine should an unsafe discharge be identified. Placed under observation rather than full admission could lead to a huge bill you are not covered for and probably cannot afford.
Medicare does not pay while you are under observation because those services are considered outpatient care.  Do not sign or authorize anything until you see an admission slip. You are not admitted into the hospital until you sign this piece of paper.
Be an assertive patient. Know your rights.

Goodbye Winter Hello Spring

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What does one think of when the first day of Spring arrives? Other people are perhaps thinking of gardening, remodeling, construction, and more rain to come right? At ILSNC, pirates are sailing the seas and a great deal of planning and implementation go into making Pirate Palooza happen. Folks have so much fun at Pirate Palooza, and the great staff behind the scenes makes it look so easy. The 8th year of Pirate Palooza in Chico brings more feasting, fun, entertainment, and treasure that it is going to be a blast. Not out of a smoking cannon, but simply so much fun. Some tickets are still available for Pirate Palooza, so come on over to the ILSNC office in Chico or call 800-464-8527 to get them. You can even grab a table to bring a work team, a family, or friends together for a Saturday evening out doing something joyous and make some memories.  Share with co-workers, family, and friends.

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MEDI-CAL DENTAL COVERAGE PARTIALLY RESTORED

Legislative leaders and Gov. Jerry Brown (D) have  agreed on a budget plan that restores partial funding for dental services in Medi-Cal, California’s Medicaid program.

Oral HealthNorthern California legislators and dental providers have been at the forefront of a campaign over the past four years to get dental coverage for Medi-Cal adults restored. For many advocates and stakeholders, this week’s budget news was considered a partial victory. Although not the complete restoration of $131 million sought, the state plans to spend about $16.9 million this fiscal year and $77 million next year on dental coverage. The money will provide preventive care, dental restorations and full dentures for adult beneficiaries of Medi-Cal.

denticalRestoring adult coverage in Denti-Cal was considered a priority for California Senate President Pro Tempore Darrell Steinberg (D-Sacramento).

“Dental care is so essential to physical health and employability,” Steinberg said. “The current alternatives are gum disease and use of hospital emergency rooms at the expense of taxpayers, which is unacceptable.”

Lindsey Robinson, a pediatric dentist in Grass Valley and president of the California Dental Association, called the agreement “a significant achievement in the effort to restore all adult Denti-Cal services and a step in the right direction to address the oral health care crisis facing millions of Californians.”

by Mari Edlin, California Healthline Regional Correspondent

Read the rest of the article at http://www.californiahealthline.org/features/2013/medical-dental-coverage-partially-restored.aspx#ixzz2Wt8niGJz