They're sending her home too soon?
A voice on the phone says she's being discharged, and two days ago she couldn't stand up without help. Nobody asked you. You have more power here than anyone is going to tell you about — and some of it expires at midnight on the day she's set to leave.
Three things worth knowing before she's out the door. All free. All yours.
You can appeal the discharge, free — and she stays while it's reviewed.
Somewhere in her paperwork is a form called "An Important Message from Medicare About Your Rights" (form CMS-10065). Every Medicare inpatient gets one. It carries a phone number for an independent reviewer — the BFCC-QIO, not the hospital. If you believe she's being sent home too soon, call that number and request a fast appeal. If no one has handed you the form, ask for it out loud, today.
- Call by midnight of the planned discharge day, and before she leaves the building.
- She is not discharged while the review happens.
- During a timely review you are not billed for those extra days — only the usual coinsurance and deductibles.
- The hospital has to prove the discharge was right. You don't have to prove it wasn't.
The one thing not to do: simply refuse to leave without filing. Dig in without appealing and you can be billed for every extra day. File the appeal, and you cannot. See the official Medicare fast-appeal page →
"Is she admitted as an inpatient, or under observation?"
Walk to the nurses' station and ask it in those words. It sounds like a technicality. It decides whether Medicare will pay for rehab at all. If she is "under observation," she is legally an outpatient — in a hospital bed, on a ward, for days — and Medicare pays for a skilled nursing rehab stay only after a 3-day inpatient stay. Observation days do not count, no matter how many nights she spent in the bed.
Families find this out at the billing office, after the rehab stay, with a bill in the tens of thousands — having done nothing wrong. Ask on day one. Ask again the next day, because the status can change. And if she was admitted as an inpatient and then switched to observation, that switch can be appealed while she's still in the hospital. See Medicare's skilled-nursing coverage rules →
"She's plateaued" is not a legal reason to stop paying.
The same fight waits at the rehab facility, on a shorter clock. When they say coverage is ending, you can appeal to the same independent reviewer (BFCC-QIO) — and "she's stopped improving" is not a valid basis for denial. Under the Jimmo settlement, Medicare covers skilled care needed to maintain a condition or slow decline, not only to improve it. File the fast appeal by the deadline on the notice they give you. See the Center for Medicare Advocacy on appeals →
Free help that has nothing to sell you
Four numbers worth having in your hand before she leaves.
The BFCC-QIO
The independent reviewer. The number is printed on the Important Message from Medicare. This is the discharge appeal itself.
The hospital's patient advocate
Free, already on site, and the fastest way to change the temperature of the conversation. Ask for them by name.
SHIP
Your State Health Insurance Assistance Program — free, confidential, unbiased Medicare counseling. Nothing to sell.
1-800-MEDICARE
1-800-633-4227 — or her Medicare Advantage plan directly if she has one. The official line for coverage questions.
Deadlines and financial liability depend on the exact notice you were given and on your own facts. Follow the instructions printed on the form, and confirm every date with the organization named on it. This page is educational — it is not medical or legal advice, and co-op.care is a member-owned cooperative forming in Boulder, Colorado, not a law firm or a licensed provider.
Get paid to give care
The real programs that pay family caregivers — CDASS, VA, HSA/FSA, and more.
The honest cost math
Home vs. a facility — what each really costs a month, and the funding most families miss.
Dementia care you may not know about
The Medicare GUIDE Model — a care navigator, training, and up to $2,500/yr respite.
What Medicare sends home — and the 156 hours it doesn't.
Win the appeal or not, most of the time she comes home. Medicare may send a nurse and a therapist a few hours a week — real, and free if she qualifies. What it will not send is anyone to help her out of the bath, cook dinner, or be in the house at two in the morning. There are 168 hours in a week; a generous home-health package covers about twelve of them.
That gap — the actual hours — is the one thing co-op.care is building: care by neighbors who own the work, so they stay. We're early, and honest about it. If what she needs is a person in the house, start here — free, about five minutes, no card.