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Patient & FamilyHandbook
www.selectmedicalcorp.com
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We are pleased to welcome you and your family to SelectSpecialty Hospital. Our top priority is to ensure that youreceive high-quality care in an environment in which youfeel safe, well cared for and comfortable.
This handbook is designed as a reader-friendly guide that
will answer some of the questions you may have about SelectSpecialty Hospital. Throughout your stay, please feel freeto ask any questions you may have. Members of our teamare always available to answer questions about your care,treatment plan or hospital policies. We believe one of thereasons why Select Specialty Hospital has become a specialresource within our community is due to our responsivenessto each patients individual needs.
At Select Specialty, you will find a special environmentthat creates a strong bond between patients and caregivers.
As a smaller hospital, we are able to provide highly personalized
and resource-intensive care to our patients. Our team ofdedicated professionals is committedto making your hospitalstay a positive experience for both you and your family.
Thank you for entrusting us with your care.
Welcome to Select Specialty Hospital
Photography by Rebecca Underkoffler
www.rebeccaunderkoffler.com
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INTRODUCTION TO SELECT SPECIALTY HOSPITAL 5
ADMISSION PLANNING & PREPARATION 8
OVERVIEW OF YOUR TREATMENT TEAM 10
PATIENT ACCOMMODATIONS 16
FOR YOUR SAFETY & SECURITY 17
FOR FAMILY, FRIENDS & SIGNIFICANT OTHERS 22
PATIENT RIGHTS AND RESPONSIBILITIES 23
NON DISCRIMINATION POLICY 26
BILLING, MEDICAL RECORDS & HEALTH INFORMATION 26
LEAVING SELECT SPECIALTY 31
IMPORTANT MESSAGE FROM MEDICARE 34
Happiness resides
not in possessions
and not in gold;
the feeling of
happiness dwells
in the soul.
Democritus
Contents
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AN OVERVIEW
Due to the complexity of theirconditions, Select SpecialtyHospital patients require alonger duration of acute care.
Our patients no longer requirethe services of a short-termacute care hospital, but arenot ready to be transferredto a less-intensive dischargesetting, such as rehabilitation,skilled nursing, assisted livingor home.
Select Specialty Hospitaloffers an optimal environmentfor these patients by providing
a longer length of stay anda more resource-intensivelevel of care. Our hospitalis fully staffed by physicians;nurses; respiratory therapists;Case Managers; physical,occupational and speechtherapists; dieticians; andpharmacists. Our dedicatedteam works closely withreferring physicians and Case
Managers to ensure thatpatients receive a combinedapproach of intensive nursingcare, focused respiratory servicesand individualized therapies.
As a long-term acute carehospital, Select Specialtyoffers a variety of servicesfor patient with critical andcomplex medical and surgicalconditions including but not
limited to the following:
Medically ComplexConditions
Pulmonary Conditions
inclusive of vent weaning Neurological Disorders Cardiac ConditionsWound Care Renal Disorders Infectious Diseases Bariatric Care Cancers Post-Trauma Care Surgical Complications
OUR MISSIONSelect Specialty Hospital iscommitted to provide thehigh-quality medical careand innovative approachesto return each patient to themost productive and fulfillinglife possible, based on thepatients ability. Our greatestasset is our peopleoneindividual helping another
all working together towarda common goal. We arecommitted to excellence inour staff, our facility and ourvalues system. We are a teamstriving to be the best forthe best: our patients.
Introduction to Select Specialty Hospital
5
You must be
the change you
wish to see in
the world.
MahatmaGhandi
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The world is
but a canvas to
our imaginations.
Henry DavidThoreau
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COORDINATION
Admission to SelectSpecialty Hospital is carefullyorchestrated through our
Admissions Department to
ensure that all patient needswill be met and to ensurea smooth transition.
CONFIDENTIALITY
During the admissionprocess, we will ask youto identify one contactperson. This person will bethe individual contactedfor discharge planning andif there is a change incondition or if the patientis unable to give consentfor special procedures. In aneffort to protect the privacyof our patients, we will onlygive out patient informationto the designated contactperson. Please help us byletting other family membersand friends know who the
contact person is.WHAT TO BRING
Clothing Although wewill provide patient gowns,you may bring a robe andslippers. You may be asked tobring in your own clothes
when approaching dischargeor working with the Therapystaff. When away from yourbed, you are expected to wear
Admission Planning & Preparation
Drugs and Medication Please do not bring anydrugs, vitamins or herbalsupplements to the hospital.If your physician writes anorder for you to bring inhome medications, the nurse
will discuss this with you.
Valuable and Lost Items Patients are asked not tobring items of value to thehospital. We suggest that youkeep no more than $5.00in your room for smallpurchases. Select Specialty is
not responsible for lost moneyor valuables brought intopatient rooms.
Please store your eyeglasses and dentures in a safeplace when not in use. Thenurse will provide you witha special dentures box. Pleasedo not wrap your eyeglassesor dentures in a tissue orleave them on your meal tray.
The hospital cannot beresponsible for lost eyeglassesor dentures. If you losesomething, please notify yournurse or Case Manager forassistance. Found articles aremaintained for 30 days.
WHAT NOT TO BRING
Prohibited PersonalProperty and Activities
We require that every possibleprecaution be taken to protect
the health and welfare ofall patients admitted to ourhospital. Consequently, duringyour hospital stay, patients,family members and othervisitors are not permitted tohave any of the followingitems in their possession:
Firearms & Ammunitions Knives or other weapons Drugs or alcohol Plug-in electrical devices
(unless approved by hospitalpersonnel)
a bathrobe and appropriatefoot coverings. Due to thehazard of falling on slipperysurfaces, patients are notallowed to be out of bed intheir stocking feet.
Personal Items Pleaselimit what you bring to thehospital to clothing andpersonal care items. If thereis an item that you feel
will make your stay morecomfortable, please discuss thisneed with the charge nurse.
Insurance Information If you werent able to providecopies of your insurancecards at the time of youradmission, please be sure tohave your nurse bring yourinsurance cards to our
Admission Coordinator forcopying. These cards directus on how to bill for ourservices on your behalf. Any
changes or clarifications ofinsurance coverage shouldalso be conveyed immediately.
While the patient is ultimatelyresponsible for his or herhospital bill, the correctand complete insuranceinformation will ensure thatyour bill is submitted to yourcorrect insurance carrier.
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MEDICAL STAFF
The physician who admitsyou is responsible fordirecting your care whileyou are in the hospital. Yourphysician, as the coordinatorof your treatment program,should be consulted ifyou have questions aboutyour condition or illness.
A full range of consultingphysicians and alliedprofessionals are available.
NURSING STAFF
Director of ClinicalServices The Director ofClinical Services is a registerednurse who supervises theclinical care provided by themulti-disciplinary team.
Charge Nurse A ChargeNurse is responsible fordirecting and coordinatingnursing care on each shift.Please feel free to contactthe charge nurse if you have
questions or concerns.Professional RegisteredNurse (R.N.) You canalso direct your questions tothe R.N. who works closely
with the attending physicianto coordinate your care plan.
While performing hands-onnursing services, such asassisting with procedures and
administering medications,
the professional registerednurse evaluates your conditionand the appropriateness ofyour care.
Licensed Practical Nurse(LPN) The LPN worksclosely with the R.N. incaring for you. He or she
will assist with examinationsand procedures and administermedication. The LPN assiststhe R.N. in providing youand your family with anyhealth-related instructionyou may need.
Nursing Assistant (NA) Nursing Assistants assist theR.N. in the provision ofpatient care activities. Theassistant will help you remainas comfortable as possibleduring your stay at SelectSpecialty Hospital. He or she
will assist in the care for yourdaily needs such as bathing,
feeding, walking, dressing,changing your bed linens andwill also perform other dutiesas directed by the R.N.
10
It is better to
light one candle
than to curse
the darkness.
ChineseProverb
Overview of Your Treatment Team
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Discharge planning in factbegins on the day of admission.The Case Manager can alsogive you a weekly updatefollowing the team meetingconducted for you or onbehalf of your loved one.The Case Manager acts as theliaison between the patient,his or her family and thetreatment team, the insurancecompany and other non-clinical involved parties.
Dietitian A RegisteredDietitian (RD) monitors your
nutritional needs. The RDmonitors things like your
weight, what you eat, andidentifies special dietary needssuch as snacks, tube feedings,feedings through your veins,etc. The RD is available toprovide instructions to youand your family related toyour dietary needs. If you havequestions, please ask your
nurse to contact the Dietitian.
Infectious Disease AnInfection Control Specialistmonitors laboratory resultsrelated to infections and
works with the health careteam to ensure you receiveappropriate care. If you havespecific questions aboutinfections, you may request
to speak to this individual.
INTERDISCIPLINARY TEAM
CONFERENCES
Interdisciplinary teamconferences are typically heldon a weekly basis. At eachconference, disciplines presentan assessment of the patient,evaluate clinical progress todate, discuss discharge barriersand determine the subsequentgoals that need to be attainedin order for discharge tooccur. The patient and familymembers do not attend theseconferences. The CaseManager will update you on
key points including dischargeplanning options that werediscussed during the teammeeting. Individual meetings
with the Case Manager andthe treatment team can bearranged upon request.
FAMILY & SIGNIFICANT OTHER
INVOLVEMENT
The family/significant other
component at Select SpecialtyHospital is designed toenhance patient and familyinvolvement in the treatmentand recuperation process.It is the belief of SelectSpecialty Hospital that a directcorrelation exists betweenpatient/family/significant otherinvolvement and the level ofpatient improvement.
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CLINICAL STAFF
Occupational TherapistAn occupational therapistis a health care professional whoprovides rehabilitation servicesto patients with physicaldisabilities and/or relatedpsychological impairments.Upon admission, theoccupational therapist willscreen the patient to determineif he/she could benefit fromtheir services. If the patientdoes require these services, adoctors order will be receivedfor evaluation and treatment.
Pharmacist Our ownpharmacists fill medicationand intravenous therapy ordersfor patients at Select SpecialtyHospital. A clinical pharmacistis available to answer questionsand make sure medicationsare available. The pharmacist
will offer needed informationto patients or family membersabout medications to be taken
at home upon discharge.
Physical Therapist Aphysical therapist is a healthcare professional who providesrehabilitation services for avariety of physical conditions.Upon admission, the patientis screened by the physicaltherapist to determine if he/she will benefit from physical
therapy services. If the patientdoes require these services, adoctors order will be receivedfor evaluation and treatment.
Respiratory TherapistThe respiratory therapistsare specialists who deal withbreathing problems. Theyare specially trained to work
with complicated medicalequipment such as ventilators.Our therapists are here 7 daysa week, 24 hours a day toinsure that any breathingproblems are taken care of as
quickly as possible.
Speech-LanguagePathologistA speech-language pathologistis a health care professional
who offers rehabilitationservices for patients who havecommunication and swallowingdisorders. Upon admission,the speech-language pathologist
will screen the patient to
determine if the patient couldbenefit from their services. Ifthe patient does require theseservices, a doctors order willbe received for evaluation,diagnosis and treatment.
OTHER STAFF
Case Manager The CaseManager is your primary contactfor discussing your discharge
planning from the hospital.
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We are what we
repeatedly do.
Excellence, then,
is not an act,
but a habit.
Aristotle
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YOUR BED & ROOM
Bed or room assignments atSelect Specialty Hospital arebased upon your diagnosis andbed availability. Since hospitalbeds are electrically operated,your nurse will instruct youon how to work the control.Should you need assistance,please ask your nurse.Remember, your hospital bedis probably higher and narrowerthan your bed at home.Bedside rails are for yoursupport. They may be raisedat night or during the day for
use in turning and positioningas you rest and recover.
CALLING YOUR NURSE
A button to call your nurseis located at your bedside.
When you press the button,the nursing station is alertedthat you need assistance and alight flashes above the door. Astaff member will respond to
your signal as soon as possible.In addition, every bathroomis equipped with an emergencycord should you need assistancefrom your nurse.
FOOD SERVICES
Wholesome, nourishing andwell-balanced meals are animportant part of yourtreatment and recovery. SelectSpecialty Hospital makes every
effort to provide nutritiousmeals that are preparedaccording to your doctorsorders. On a daily basis, Foodand Nutrition Services willprovide you with a menuthat matches your doctorstreatment plan and the diethe or she has specified thatyou follow. Occasionally, yourmeals may be delayed if youare scheduled for a specialtest or treatment. Wheneverpossible, you will be servedafter your test or examination.
INTERPRETER SERVICES
This service is provided bythe hospital at no charge tothe patient. Interpreters areavailable for translation of signlanguage and several foreignlanguages. Additionally, SelectSpecialty Hospital has accessto AT&Ts Language Line,
which is available 24 hoursa day and can interpret morethan 100 languages anddialects. Your nurse can obtainthis service when needed. Forthose who are deaf, hearing-impaired or speech-impaired,TDD units are available. Toreceive a unit, ask your nurseor have a family member callyour Case Manager.
MAIL & FLORAL DELIVERIES
Mail will be delivered to yourhospital room by a hospitalemployee. If you wish to mailletters, you may bring them orhave someone bring them tothe Nursing Station. Flowers
will be delivered to your roomby a hospital employee.
RELIGIOUS AFFILIATIONS
(SPIRITUAL/CULTURAL NEEDS)
Any patient (or familymember) who desires to talk
with a religious advisor shouldnotify his or her nurse. Efforts
will be made to contact thepatients personal clergy. If noone is available, arrangementscan be made with one of thelocal houses of worship. Otherspiritual or cultural needs maybe communicated to your CaseManager to help meet yourspecific concerns or needs.
TELEPHONES
Telephones are provided ineach patient room. Long-distance calls must be billedto your personal calling cardor your home phone, orplaced collect. If you areusing the telephone or
watching television, pleasebe courteous of others inyour immediate area, interms of audio volume andtime of day or night.
The use of cellular phonesis prohibited in many areasof the hospital. To ensure
patient safety, cell phonesmust be turned off theycannot be placed in thestandby mode. Please abideby signs posted throughoutthe hospital.
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Patient Accommodations
COMMUNICATION
Effective communication withour patients and their familiesis important to all of us atSelect Specialty Hospital.Should you need explanationor have a concern about yourrights or responsibilities, weoffer these guidelines. Pleaseaddress the concern directly
with the staff caring for you.
For Your Safety & Security
The parties directly involvedare the most likely to have thebest information and shouldbe the starting point to resolvethe situation. If resolution isnot reached, please ask the staffto involve the charge nurse.Should these steps not resolvethe issue, you are encouraged
to contact the hospital CEO.
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ELECTRICAL SAFETY
Electrical appliances broughtfrom home, such as radiosand razors, are not permittedunless they are batteryoperated, since they may notmeet the Hospitals electricalsafety standards.
FALL PREVENTION
While you are in the hospital,your illness may increaseyour risk of falling. Someprecautions that you can taketo avoid falling include:
Use your call bell to call
the nurse before getting outof bed.Wear slippers with non-skid
soles. We will provide a pairif you need them.
Keep objects like yourphone, call bell and personalitems within reach.
FIRE DRILLS
For your protection, Select
Specialty Hospital conductsfire and disaster drills regularly.Please do not be disturbed ifyou see or hear evidence ofa drill. During an emergency,some or all of the followingmay occur: a loud alarmsignal will be sounded, fireand smoke barrier doors willclose, the door to your room
will be closed by hospital
personnel, and elevators willreturn to the ground floorand cease to operate. SelectSpecialty staff are trained infire protection and evacuation.Please follow the instructionsof firefighters and hospitalpersonnel.
SAFETY DEVICES
Our goal at Select SpecialtyHospital is to help yourecover quickly and safely.To achieve this goal, we may,in special situations, userestrictive safety devices thatmust be ordered by yourphysician. If you have anyquestions about the use ofany restrictive device, pleasefeel free to ask our staff oryour doctor.
SECURITY
Security is provided for theprotection of our patients,as well as our employees and
visitors 24 hours a day.
SMOKING
As Select Specialty Hospitalis concerned about thehealth of its patients, visitorsand employees, we are anon-smoking facility.
For Your Safety & Security(continued)
19
First say to
yourself what you
would be; and
then do what
you have to do.
Epictetus
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Nothing can
bring you peace
but yourself.
Ralph WaldoEmerson
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We believe that visitation fromfamily, friends and significantothers helps our patientsrecover more fully and quicklyby keeping them happy and
content. Since we care for sickindividuals, we do have certainpolicies and procedures inplace to ensure that ourhospital runs smoothly andthat our patients receive carein a non-disruptive setting.
We are appreciative of thosewho respect and abide bythese policies, which supportand enable the provision of
high-quality patient care.
All visitors adhere to theestablished visiting hours ofour hospital
Children (12 years of ageand under) must be
accompanied by an adult,and cannot be disruptive toother families and patients.
Children cannot be leftalone with the patient.Children should not visit
who have had or haveexposure to viral illnesses,especially chicken pox.
Staff does have the authorityto ask visitors to leave if they
are disruptive to families,patients or the environment. Please do not visit if you
are ill. Please wash your hands
upon entering and leavingpatient rooms.
Please practice coughetiquette: cover your mouthand wash your hands.
Family members and
visitors of any patient inisolation must followisolation procedures. If apatient is in isolation, there
will be a sign on the door.You may not enter thepatients room without firstreviewing the necessaryprecautions and procedures
with hospital staff.
TIPS FOR VISITORS
While we appreciate yourassistance with patients whenthey need help; please ask thenursing staff for instructionsbefore assisting a patient withan activity or exercise.
Do not transfer the patientfrom his/her bed to a chair,
wheelchair or bedsidecommode or vice versa
without staff assistance.Always report water or spills
on the floor to the nursingstaff as soon as it occurs oris noticed.
If you plan to assist a patientin walking, ask the staff to
teach you how to do thissafely and how to properlyuse a gait belt.
Never assist a patient withexercises unless you have beeninstructed by a professional.
Do not remove restraints.If you have questions orthere is a problem with therestraints, please notify thenursing staff immediately.
Please follow posted signs onpatient room doors. If you areunsure of the information, aska Select Specialty Hospital
staff member before enteringthe patients room.
For Family, Friends & Significant Others
As a patient at SelectSpecialty Hospital youhave the right to:
Respect and Privacy As apatient you have the right to
personal respect and privacyand to be free from neglect orabuse in your care.
Informed Consent Youhave the right to ask questionsand be involved in decisionsabout your care and to talk
with your family, friends orpartner about such decisions.
Caregiver Identification You have the right to knowthe names of your doctorsand nurses and other peoplecaring for you.
Safe Care You have theright to demand that anydoctor or nurse or otherperson wash his or her handsbefore examining you. As apatient you will be free frommental and physical abuseand free from restraints exceptas authorized in writing bya physician for a specifiedand limited period of time.
Patient Rights and Responsibilities
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In the middle
of every difficulty
lies opportunity.
Albert Einstein
Participation You havethe right to refuse any drug,treatment or procedure, unlesssuch refusal is prohibited bylaw. And, you have the rightto refuse to participate in anyexperiment or research project.
Communication Youhave the right to demand afull explanation in a languageyou can understand of thecare to be given, its risks andalternatives, if any, so thatyou can give an informedconsent before receivingnon-emergency procedures.
And you have the right toaccess an individual or agency
who is authorized to act onyour behalf to assert or protectyour rights as set forth inthis document.
Emergency Services You have the right toprompt emergency services
when needed and written
explanation of anything thatgoes wrong with your care.
Confidentiality You havethe right to confidentialityregarding your medicalrecords and treatment.
Financial Information You have the right to infor-mation and counseling onavailable financial resourcesto help pay for care.
Visitors You have theright to an explanation of thehospital rules and policiesregarding visitors.
Complaints You have
the right to file a complaintwith the hospital regardingany aspects of your careand to know the name andtelephone number of theperson to whom you canmake a complaint.
As a patient at SelectSpecialty Hospital you havethe responsibility to:
Disclosures You have theresponsibility for providing,to the best of your knowledge,accurate and completeinformation about presentcomplaints, past illnesses,hospitalization, medications,and other matters relatingto your health.
Payment You have theresponsibility for assuring thatthe financial obligations foryour health care are fulfilledas promptly as possible.
Consideration You havethe responsibility to beconsiderate of the rights ofother patients and Hospitalpersonnel.
Patient Rights and Responsibilities (continued)
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Our greatest
glory is not in
never falling but
in rising every
time we fall.
Confucius
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It is the policy of Select SpecialtyHospital to comply with theCivil Rights Act of 1964, 42U.S.C. Section 2000d, andimplementing regulations 45C.F.R. Part 80; Section 504 ofthe Rehabilitation Act of 1973,29 U.S.C. Section 794, andimplementing regulations, 45C.F.R. Part 84; and the AgeDiscrimination Act of 1975, 42U.S.C. Sections 6101 et seq.,and implementing regulations45 C.F.R. Part 91.
Select Specialty Hospitaladheres to an equal opportunity
policy for all persons seekingadmission and treatment aspatients. The hospital doesnot discriminate because ofrace, color, national origin,disability, sexual orientationor age. With regard toemployment, the hospital doesnot discriminate on the basis ofdisability; in addition, there isno discrimination on the basisof race, color and national origin
where such discriminationwould have a discriminatoryeffect on beneficiaries.
Non Discrimination Policy
CHARGES
Select Specialty Hospital willfile hospital claims to yourinsurance company(s) providedyou supply our Business Office
with your insurance information.While we will bill yourinsurance directly; the patientis ultimately responsible for
payment of his/her hospital bill.All physicians and specialistsinvolved with your treatment
will bill you or your insurancecompany directly. These bills
will be separate from hospitalbilling. You will be responsiblefor paying charges not paid byyour insurance company.
Please note that SelectSpecialty is a hospital, not an
insurance carrier. While we canprovide some degree of guidance,the ultimate responsibility forinsurance coverage and payment ofmedical bills belongs to the patient.
HEALTH INFORMATION SERVICES
A complete record of treatment is
maintained by Health InformationManagement/Medical Records, perfederal regulations. Questions aboutthe patient medical record may bedirected to the Health Information/Medical Records Department.Patients have a right to a copy oftheir medical record. Please contactthe Manager of Health Informationto learn about the process andassociated cost to obtain a copy of
your medical record.
Billing, Medical Records & Health Information
To climb steep
hills requires a
slow pace at first.
Shakespeare
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Strength does
not come from
physical capacity.
It comes from an
indomitable will.
MahatmaGandhi
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When your doctor deter-mines that you no longerneed all of the specializedservices provided in a hospi-tal, he or she may dischargeyou. The Case Manager atSelect Specialty Hospital willhelp arrange for the servicesyou may need after your dis-charge. If you are a Medicarepatient, we must follow thefederal guidelines for admis-sion and continued stay. Ifyou have a non-governmentfunded payment source, that
payer directs the hospital onthe medical necessity of yourcare which determines whatthey will or will not pay for.Therefore, you should findout which services will or
will not be covered and howpayment will be made.Consult with your doctor,hospital Case Manager,patient representative andyour family in makingpreparations for care afteryou leave the hospital. Donthesitate to ask questions.
33
There is only
one way to hap-
piness, and that
is to cease wor-
rying things
which are
beyond the
power of our
will.
Epictetus
Leaving Select Specialty
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Your Right to anImmediate Appeal withoutFinancial Risk When youare advised of your planneddate of discharge, if youthink you are being asked toleave the hospital too soon,you have the right to appealto your Quality ImprovementOrganization (also knownas a QIO). The QIO isauthorized by Medicare toprovide a second opinionabout your readiness to leave.
You may call Medicaretoll-free, 24 hours a day, at
1-800-MEDICARE (1-800-633-4227), or TTY/TTD:1-877-486-2048, for moreinformation on asking yourQIO for a second opinion.If you appeal to the QIO bynoon of the day after youreceive a noncoverage notice,you are not responsible forpaying for the days you stayin the hospital during the
QIO review, even if the QIOdisagrees with you.The QIO will decide within
one day after it receives thenecessary information.
Other Appeal Rights: Ifyou miss the deadline forfiling an immediate appeal,you may still request a reviewby the QIO (or by your Plan,if you are a Plan enrollee)before you leave the hospital.However, you will have topay for the costs of youradditional days in the hospitalif the QIO (or your Plan)denies your appeal. You mayfile for this review at theaddress or telephone numberof the QIO (or of your Plan).
34 35
YOUR RIGHTS AS A HOSPITAL
PATIENT
You have the right to receivenecessary hospital servicescovered by Medicare, orcovered by your MedicareHealth Plan (your Plan)if you are a Plan enrollee.
You have the right to knowabout any decisions that thehospital, your doctor, yourPlan or anyone else makesabout your hospital stayand who will pay for it.
Your doctor, your Plan orthe hospital should arrangefor services you will needafter you leave the hospital.Medicare or your Plan maycover some care in yourhome (home health care)and other kinds of care, ifordered by your doctor orby your Plan. You have aright to know about theseservices, who will pay forthem, and where you can
get them. If you have anyquestions, talk to yourdoctor or Plan, or talk toother hospital personnel.
YOUR HOSPITAL DISCHARGE &
MEDICARE APPEAL RIGHTS
Date of Discharge When your doctor or Plandetermines that you canbe discharged from thehospital, you will be advisedof your planned date ofdischarge. You may appealif you think that you arebeing asked to leave thehospital too soon. If youstay in the hospital afteryour planned date ofdischarge, it is likely thatyour charges for additionaldays in the hospital willnot be covered by Medicareor your Plan.
Important Message from Medicare
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Happiness depends
more on the
inward disposition
of mind than
on outward
circumstances.
BenjaminFranklin
YOUR NAME
YOUR ATTENDING PHYSICIAN
YOUR PRIMARY NURSE
YOUR ROOM NUMBER/YOUR PHONE NUMBER
OTHER INFORMATION
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NOTES NOTES
39
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NOTES