Challenging A Hospital Discharge: Know Your Rights

If you feel that you are being discharged from the hospital prematurely, there are steps you can take to appeal the decision. Firstly, it is important to be aware of your rights as a patient. Hospitals are required to provide patients with information about their discharge and appeal rights, and you have the right to be involved in any decisions regarding your hospital stay and subsequent care. If you feel that you are being rushed out of the hospital, you can file an appeal to halt the discharge process, but it is important to act quickly. You can contact your local Medicare Quality Improvement Organization (QIO) to initiate the appeal process and request a review of your discharge. During the review process, you can remain in the hospital without incurring additional charges until a decision is reached.

Know your rights: Understand discharge and appeal rights, and any applicable penalties for hospitals

If you are hospitalised and feel that you are being released too early, you can take steps to appeal your discharge. It is important to know your rights and how to exercise them. Hospitals have a duty to help patients and their families find and arrange needed care, but this duty is sometimes compromised by the desire to discharge patients quickly.

In most instances, you can appeal on the day of discharge and stay in the hospital without financial liability until noon the day after the hospital has received QIO notification. The hospital cannot force you to leave before a decision is reached. If you are in the hospital for three days or less, the hospital only needs to give you one notice. If you receive a discharge decision but are not ready to leave, contact your local Medicare Quality Improvement Organization (QIO) immediately. A QIO is a group of doctors and other professionals who monitor the quality of care delivered to Medicare enrollees. They are not affiliated with a hospital or HMO, and their contact information should be provided to you by the hospital.

If you have a Medicare health plan, the QIO will notify your plan and the hospital. By noon the day after the QIO notifies the hospital, the hospital will give you a "Detailed Notice of Discharge". The QIO doctors will review the medical necessity, appropriateness, and quality of hospital treatment furnished to you. The hospital cannot discharge you while the QIO is reviewing the discharge decision, and you will not be charged for the additional days in the hospital. If you don't agree with the QIO's decision, you can ask it to reconsider within three days.

If the hospital hasn't adequately addressed your need for a "safe discharge", you may have grounds to contest its decision. Safe discharge means that a patient has appropriate care and support in place once they are discharged. There are strict definitions for determining if a discharge is safe, which can be presented to your insurance provider. Hospitals that release patients too early can be financially penalised if the patient is readmitted soon after.

You have the right to be involved in any decisions about your hospital stay and to know who will pay for it. You also have the right to get the services you need after you leave the hospital. Before a hospital transfers a patient to another health facility, they must make arrangements for admission with the receiving health facility.

Act fast: File an appeal as soon as possible to avoid financial liability

If you feel that you are being discharged from the hospital prematurely, it is important to act swiftly to avoid financial liability. Every older adult admitted to a hospital has the right to challenge a discharge if they feel unprepared to leave. However, few people understand the process involved, and seniors and their families are often caught by surprise when a transfer from the hospital is imminent.

To avoid financial liability, it is crucial to file an appeal as soon as possible. Within two days of your admission to the hospital, you should receive a notice called "An Important Message from Medicare about Your Rights." This notice will explain your discharge and appeal rights. It is important to carefully read this notice and be aware of your rights. If you do not receive this notice, be sure to ask your provider for it.

The appeal process can vary depending on your specific situation. If you are a Medicare beneficiary, you should contact your local Medicare Quality Improvement Organization (QIO). The contact information for the QIO should be provided in the discharge notice. The QIO will conduct a review of the discharge, including the medical necessity, appropriateness, and quality of the hospital treatment you received. The hospital cannot discharge you while the QIO is reviewing the decision, and you will not be financially liable for the additional days in the hospital.

In some cases, you may need to work with your healthcare provider to submit the necessary documentation warranting an extended hospital stay. This may include information about your medical condition and why an extended stay is medically necessary. It is important to be proactive and communicate your concerns to your doctor and hospital staff as soon as possible.

By acting fast and filing an appeal, you can buy yourself crucial extra days of coverage and avoid financial liability for any additional days in the hospital while awaiting the outcome of your appeal.

Contact the QIO: Reach out to the Quality Improvement Organization to review your case

If you feel that you are being discharged from the hospital prematurely, you can contact the Quality Improvement Organization (QIO) to review your case. QIOs are groups of doctors and professionals who monitor the quality of care delivered to Medicare enrollees. They are not affiliated with any hospital or HMO, and the federal government pays them.

You should receive a notice called "An Important Message from Medicare about Your Rights" within two days of your admission and before your discharge. This notice will contain the name and phone number of your Medicare QIO, along with instructions on how to file a complaint. If you do not receive this notice, ask your provider for it. The notice will explain your rights, including your right to appeal a planned discharge, and you must read, sign, and date it.

If you receive a discharge decision but feel that you are not ready to leave, contact your local QIO immediately. You should do this by noon on the first business day after receiving the discharge notice. The hospital cannot discharge you while the QIO is reviewing the decision, and you will not be charged for the additional days. The QIO doctors will review the medical necessity, appropriateness, and quality of the hospital treatment provided to you. Once you request a QIO review, the hospital must give you a “Detailed Notice of Discharge."

If you miss the deadline for a fast appeal, you can still ask the QIO to review your case, but different rules and time frames will apply, and you may be responsible for the cost of your hospital stay past the original discharge date.

Advocate for your interests: Discuss concerns with your doctor and request their support

If you feel that you are being discharged from the hospital prematurely, it is important to advocate for your interests and discuss your concerns with your doctor. Your doctor can be your advocate and support you in contesting the hospital discharge. Here are some steps you can take:

Firstly, stay informed about your medical condition and expected length of stay in the hospital. Ask your doctor for updates on your progress and whether there are any changes to your treatment plan. This can help you identify any potential issues early on and address them proactively.

If you have concerns about your discharge, don't hesitate to speak to your doctor and hospital staff immediately. Express your worries clearly and ask for their assistance in resolving them. For instance, if you feel that you are being discharged too soon and require additional care, explain your situation and request their support in exploring alternative options or arranging for continued care.

In some cases, your doctor or healthcare provider may be able to submit documentation justifying the medical necessity of an extended hospital stay. They can advocate on your behalf and collaborate with the hospital to ensure a safe discharge plan. Their input can carry significant weight in influencing the hospital's decision-making process.

Additionally, be aware of your rights as a patient. Understand the hospital's "Safe Discharge" policy, which ensures that patients have appropriate care and support in place upon discharge. Familiarize yourself with the discharge and appeal rights outlined in the "Important Message from Medicare" that you should receive upon admission and before discharge. This notice includes crucial information about your rights, how to file an appeal, and the contact details of relevant organizations.

If you are a Medicare beneficiary, you can contact your local Quality Improvement Organization (QIO) and file a complaint or request a review of your discharge. QIOs are groups of doctors and professionals who independently assess the medical necessity, appropriateness, and quality of hospital treatment. They are not affiliated with the hospital and can provide an unbiased evaluation of your case.

Remember, it is your right to be involved in decisions regarding your hospital stay and to understand who will pay for the services you receive. Don't hesitate to seek clarification from your doctor or hospital staff if you have questions or concerns about your discharge. By advocating for yourself and enlisting the support of your doctor, you can effectively contest a hospital discharge that you believe is premature or unsafe.

Safe discharge: Ensure you have appropriate care and support post-discharge

Safe discharge means that a patient has appropriate care and support in place once they are discharged. There are strict definitions for determining if a discharge is safe, which can be presented to your insurance provider.

If you are a Medicare beneficiary, you should receive two notices of your rights, including discharge and appeal rights, during your hospital stay. The first should be given to you within two days of your admission, and the second before your discharge. These notices will contain the name, address, and phone number of the Quality Improvement Organization (QIO) serving the hospital, along with instructions on how to file a complaint. If you do not receive these notices, ask your provider for them.

If you feel that you are being discharged too early, you can file an appeal, or a "fast appeal," to extend your stay. This can be done on the day of your discharge, and you will generally not be financially responsible for any additional charges until noon the next day. If you file an appeal, the hospital cannot force you to leave before a decision is reached. To support your appeal, ask your surgeon or healthcare provider to submit documentation warranting that an extended hospital stay is a medical necessity.

If you are a Medicare beneficiary, you can contact your local QIO and file a complaint if you believe your discharge is premature or inappropriate. The QIO will conduct a review of the discharge, including the medical necessity, appropriateness, and quality of hospital treatment. The hospital cannot discharge you while the QIO is reviewing the decision, and you will not be financially liable for the additional days in the hospital. If you disagree with the QIO's decision, you can ask for a reconsideration, which must be issued within three days.

Frequently asked questions