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  1. #1

    Default Senior on Medicare Discharged from Hospital Too Early After Major Surgery

    My question involves potential malpractice in the state of Iowa.

    My 72-year-old mother has been told she needs knee-replacement surgery. The doctor that would be performing the surgery told her that she would be in the hospital for no more than two days. (I'm trusting she heard this right.) Everything I've read on knee-replacement surgery states that a stay of 3 - 5 days is the norm. When I questioned my mother on this, she said she believes it has to do with the fact that she is on Medicare with no supplemental insurance. Since Medicare does not pay at the rate of private insurance, hospitals cut the stay short to make up for their losses. (Or, perhaps, Medicare won't pay for more than 2 days in a hospital after a knee replacement? I find that hard to believe, if the senior requires it, but I don't know much about Medicare.) This got me to thinking. If this is accurate, and hospitals are discharging Medicare patients early to make up for the lower payout, could this be fodder for medical malpractice? That's if sending the senior home early results in additional/unnecessary hardship or injury or something like that.

    Thank you.

  2. #2
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    Oct 2006
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    15,934

    Default Re: Senior on Medicare Discharged from Hospital Too Early After Major Surgery

    Quote Quoting ABroadinColorado
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    My question involves potential malpractice in the state of Iowa.

    My 72-year-old mother has been told she needs knee-replacement surgery. The doctor that would be performing the surgery told her that she would be in the hospital for no more than two days. (I'm trusting she heard this right.) Everything I've read on knee-replacement surgery states that a stay of 3 - 5 days is the norm. When I questioned my mother on this, she said she believes it has to do with the fact that she is on Medicare with no supplemental insurance. Since Medicare does not pay at the rate of private insurance, hospitals cut the stay short to make up for their losses. (Or, perhaps, Medicare won't pay for more than 2 days in a hospital after a knee replacement? I find that hard to believe, if the senior requires it, but I don't know much about Medicare.) This got me to thinking. If this is accurate, and hospitals are discharging Medicare patients early to make up for the lower payout, could this be fodder for medical malpractice? That's if sending the senior home early results in additional/unnecessary hardship or injury or something like that.

    Thank you.
    I think that the most likely explanation is that Medicare will not pay for more than 2 days after knee replacement surgery. However, I would also like to point out that my boss's wife only was in the hospital for about 36 hours after knee replacement surgery and they have a really excellent Medicare supplement policy.

  3. #3
    Join Date
    Jun 2014
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    3,128

    Default Re: Senior on Medicare Discharged from Hospital Too Early After Major Surgery

    Will your mother have to go to a rehab facility? Depending on how extensive the surgery was, age and other health issues. some patients have to go to rehab for several weeks. Does your mother have original Medicare or a Medicare Advantage Plan ?

  4. #4

    Default Re: Senior on Medicare Discharged from Hospital Too Early After Major Surgery

    I'm honestly not sure which plan she has. I'll ask. She's in a low socioeconomic tax bracket (but, according to her not low enough to qualify for Medicaid). So, if original Medicare is less expensive than the Advantage Plan, then I know she'd choose the lowest-cost plan. (Clearly, I should get educated on Medicare.) She's in pretty bad shape physically and has a lot of health issues. She lives in Iowa and I live with my family in Colorado. Surgery is worrisome in any case, but I'm extra worried that with the poor shape she's in that the knee-replacement will possibly come with serious complications. To boot, she lives in a small community an hour out of Des Moines, so I'm not certain how rehab is going to work. Other than one cousin, she really has no support network. There are really no services for lower-income seniors in this small town. I have asked her to come to my city to have the surgery, but she refuses and I cannot jeopardize my job in order to care for her over what likely will be a long recovery. Lots going on here that isn't pertinent to this forum. However, I wondered how a surgeon could tell a senior in my mother's physical condition that she would only spend two days in the hospital. How could he make that call upfront rather than after the surgery depending upon how she's doing? So, that got me to thinking about how many elderly patients are discharged too early. I realize that for some 3-5 days is not necessary. I'd just read that it's the norm.

  5. #5
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    Massachusetts
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    Default Re: Senior on Medicare Discharged from Hospital Too Early After Major Surgery

    "I just read" are very dangerous words.

  6. #6
    Join Date
    Jun 2014
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    Default Re: Senior on Medicare Discharged from Hospital Too Early After Major Surgery

    Quote Quoting ABroadinColorado
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    I'm honestly not sure which plan she has. I'll ask. She's in a low socioeconomic tax bracket (but, according to her not low enough to qualify for Medicaid). So, if original Medicare is less expensive than the Advantage Plan, then I know she'd choose the lowest-cost plan. (Clearly, I should get educated on Medicare.) She's in pretty bad shape physically and has a lot of health issues. She lives in Iowa and I live with my family in Colorado. Surgery is worrisome in any case, but I'm extra worried that with the poor shape she's in that the knee-replacement will possibly come with serious complications. To boot, she lives in a small community an hour out of Des Moines, so I'm not certain how rehab is going to work. Other than one cousin, she really has no support network. There are really no services for lower-income seniors in this small town. I have asked her to come to my city to have the surgery, but she refuses and I cannot jeopardize my job in order to care for her over what likely will be a long recovery. Lots going on here that isn't pertinent to this forum. However, I wondered how a surgeon could tell a senior in my mother's physical condition that she would only spend two days in the hospital. How could he make that call upfront rather than after the surgery depending upon how she's doing? So, that got me to thinking about how many elderly patients are discharged too early. I realize that for some 3-5 days is not necessary. I'd just read that it's the norm.
    Original Medicare is not cheaper than Medicare Advantage Plans. Some Medicare Advantage Plans might be a,little cheaper than originally Medicare. Medicare Advantage Plans can also have extras like someone to take the person to and from medical appointments, someone to bring food by, etc. Unfortunately, Medicare Advantage Plans cut on other things to make money. The person must see providers,that accept their plan. There are often more hoops for doctors and patients to jump through before the plans will pay for certain things. Medicare Advantage Plans are best for those with little to no health issues.

  7. #7
    Join Date
    Oct 2006
    Posts
    15,934

    Default Re: Senior on Medicare Discharged from Hospital Too Early After Major Surgery

    Quote Quoting ABroadinColorado
    View Post
    I'm honestly not sure which plan she has. I'll ask. She's in a low socioeconomic tax bracket (but, according to her not low enough to qualify for Medicaid). So, if original Medicare is less expensive than the Advantage Plan, then I know she'd choose the lowest-cost plan. (Clearly, I should get educated on Medicare.) She's in pretty bad shape physically and has a lot of health issues. She lives in Iowa and I live with my family in Colorado. Surgery is worrisome in any case, but I'm extra worried that with the poor shape she's in that the knee-replacement will possibly come with serious complications. To boot, she lives in a small community an hour out of Des Moines, so I'm not certain how rehab is going to work. Other than one cousin, she really has no support network. There are really no services for lower-income seniors in this small town. I have asked her to come to my city to have the surgery, but she refuses and I cannot jeopardize my job in order to care for her over what likely will be a long recovery. Lots going on here that isn't pertinent to this forum. However, I wondered how a surgeon could tell a senior in my mother's physical condition that she would only spend two days in the hospital. How could he make that call upfront rather than after the surgery depending upon how she's doing? So, that got me to thinking about how many elderly patients are discharged too early. I realize that for some 3-5 days is not necessary. I'd just read that it's the norm.
    If your mother's support system is so limited where she is, why don't you encourage her to come and live with you permanently?

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