What To Do Before You Are Discharged From A Hospital

If the hospital attempts to discharge you before you feel you are ready, speak to your doctor. If your doctor is unable to extend your hospitalization, request a meeting with the discharge planner or patient advocate.  If necessary, contact your insurer and the hospital administrator. 

You probably should not go home if:

• You feel faint or disoriented.
• You are unable to keep down food or fluids.
• You are unable to go to the bathroom unassisted.
• Your pain can't be controlled with oral medication.

How To Stay If The Doctor Thinks It's Time For You To Leave

If you feel you are being asked to leave the hospital too soon, you have the right to appeal decisions made by your doctor, hospital or your managed care plan concerning:

• If you feel you are being asked to leave the hospital too soon.
• If you believe you have not been given adequate or appropriate plans for your medical care and other services you may need after you leave the hospital.
• If needed services are not in place.

The law requires that you receive advance notice in writing telling you:

• The date the physician and/or hospital plans to discharge you.
• How to appeal if you wish to remain in the hospital.
• A number to call with any problems related to leaving the hospital.

If You Have Medicare

If you feel that you are being asked to leave the hospital too soon and you have not received advance notice telling you when to leave the hospital, you should ask for your discharge notice (also called a Hospital Issued Notice of Non-coverage or HINN).  You must have this written discharge in order to appeal the physician's and hospital's decision about when you are to leave. Call the Medicare helpline at 800-Medicare.

If You Have Managed Care Type Health Insurance (such as an HMO)

If you are enrolled in an HMO or managed care plan, you have the right to an expedited review process if you feel your benefits are unfairly limited or denied, you are being asked to leave the hospital too soon, or that medically necessary services are inappropriately excluded from your coverage.  

Information To Help Argue For More Time In The Hospital 

If you need to request more time in the hospital, you may find it useful to know about a study reported in the Journal of the American College of Surgeons, that concluded  that speeding a patient's discharge from the hospital a day or two early in order to save money, results in little savings.

Researchers reviewed the total costs incurred by 12,365 patients who were discharged from the University of Michigan Health System in Ann Arbor. The study compared the costs incurred on a daily basis with how much money is saved by trimming the length of the hospital stay. The study concluded that cutting a full day off of the end of a hospital stay resulted in an average savings of only 3% or less.

What was the reason for such a minimal savings?  The study found that the most expensive days are incurred early in the hospital stay, when patients undergo expensive diagnostic testing and medical procedures.  The average charge for the last day of hospitalization was $400 to $450.  In comparison, the average cost of the total hospitalization was $17,734. 

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