Caring for Parents

While qualifying hospitalization rules vary for long term and home health insurance policies, sometimes any portion of a day while admitted counts as a full day in determining eligibility.  But for Medicare coverage, REMEMBER the three day rule: In order to received skilled care post hospital such as rehabilitation benefits, the 3 day rule is strictly defined as being admitted for 3 consecutive midnights. 

While nearly all physicians and hospital workers know the rule, there are times when a hospital case manager or “utilization management” social worker or nurse recommends discharge before the qualifying third midnight.  If the decision is subjective or a case exists for a slightly longer stay, seniors and caregivers should discuss all factors – including the loss of some Medicare benefits for rehabilitation – with the physician before the discharge occurs.

While nobody should remain in a hospital any longer than necessary, often there are subjective factors that influence discharge recommendations.  A well-advised senior patient and his or her caregiver need to understand the economic significance of the discharge decision and address any concerns with the health care provider.