KB Times
  Katten & Benson, Your Elder Law Specialists
February 2009 - Vol 2, Issue 2
In This Issue
Dad's Still Sick, Why Does He Have to Move?
Janice Lewis, Medicaid Specialist
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HCUP Facts and Figures: Statistics on Hospital Based Care in the United States, 2005
Did You Know?
  • In 1993 the average length of a hospital stay was 5.7 days
  • In 2005 the average length of a hospital stay was 4.6 days
HCUP Facts and Figures: Statistics on Hospital Based Care in the United States, 2005
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Dad's Still Sick, Why Does He Have to Move?
KB logo Bob had a major stroke, and after 2 weeks, he was still in the hospital's intensive care unit. His family was shocked when the hospital social worker came in one day to tell them that Bob had to be moved--to another hospital! What's going on here?!?
This scenario happens more often than you may think. The reason this happens is due to Medicare and the way Medicare is set up to pay hospitals.

Acute Care Hospitals
Most hospitals that we think of have emergency rooms, surgical suites, and rooms for people who either come in through the emergency room or who have scheduled surgery. Medicare has traditionally considered that people in these hospitals will be there for only a short period of time. The way Medicare decides what to pay the hospital is complicated, but very simply, Medicare pays the hospital a predetermined rate based on the diagnosis, regardless of the amount of time the patient is in the hospital. This is one reason that the length of time people stay in the hospital has become shorter (see sidebar).

Long Term Acute Care
Now, there are people who truly need to be in the hospital longer. To address this need, there are Long Term Acute Care Hospitals or Acute Specialty Hospitals. Medicare still pays a predetermined amount to the hospital, but the assumption now is that the person will require at least three weeks in the hospital, so the amount paid is significantly higher than is paid in regular acute care hospitals. Many of the Long Term Acute Care Hospitals are separate, smaller hospitals, but in some cases they are separate units housed within a regular acute care hospital. These hospitals often have intensive care units, but they do not have emergency rooms or surgical suites.
This is a very simple explanation of a very complex system, but hopefully it helps you understand that there are real reasons that drive our often fragmented health care delivery system.
Janice Lewis, Medicaid Specialist
Janice LewisJanice M. Lewis, our Medicaid Specialist, has been with Katten & Benson over five years.  She has worked in the Medicaid field since 1999.  She walks with our clients every step of the way through the complicated issues of Medicaid eligibility.  She prepares the Medicaid application, gathers all pertinent information to go with the application, submits the application to the Health & Human Services caseworker, stays in touch with the client, care facility, and caseworker throughout the Medicaid pending process, and sees the application through to completion.
Janice has been married to Grady since 1986.  They have four children and six grandchildren.  They live in Burleson, where Grady was born and raised, and are now enjoying "empty nest syndrome."  What they most enjoy is simply being with family and friends.

Please feel free to share this newsletter with your friends, colleagues and clients. We look forward to helping you and your clients with your long term care planning needs.
 
Sincerely,
 
Kim Olmedo, LCSW, CCSM, CSW-G
Elder Care Coordinator
Katten & Benson