The Process Issues Of Getting A Patient Or Loved One Transferred From A Current Hospital To Another Longer Term Type Of Hospital Or An Extended Care Facility
Questions to ask the facility that you are considering for your loved one (primary elderly) to be transferred to and the responses that you should expect:
What are the normal visiting hours? How many people can visit at one time?
Visiting hours can vary depending on the type of unit the patient is being transferred to however, usually no more than 1 to 2 immediate family members are allowed to visit the patient initially.
Can the patient leave the facility to go out with family members and then return?
Normally if the transfer is being made to an extended care facility and the patient health enough to do so, the patient could possibly accompany family members or visitors off campus for a short time frame.
Can family or personal physicians see the patient at that facility?
If the patient is being transferred to an extended care type of facility, you want to make sure that the patient is able to continue to see their primary care physician, if necessary. If the care facility insists on the patient using it’s own physician or someone else, you will have to evaluate if that is acceptable.
Will the staff make sure the patient gets regular treatments needed such as Therapy, Dialysis and/or Doctor appointments? Is transportation available for this? Will staff wait throughout the outside appointments?
Most extended care facilities will be able to accommodate these necessities in caring for the patient however, you may want to be sure as to how much of this is your responsibility versus that of the facility.
Will the patient be in a private room? How much would have to paid for the patient to be in a private room
Most extended care facilities charge more for the benefit of the patient having a private room if a private room is available.
Will the patient have a regular nurse attending to their needs?
Many facilities have various schedules for their staff and the patient having a consistent nurse or care giver that they become familiar with may be a challenge. You may want to clarify this and also learn how much the nursing or care giving team may depend on the family to provide an extra “measure” of attention to the patient.
How often do staff check on each patient?
This is another important consideration. Most hospitals try to make sure that the patient is visibly checked on by the nursing staff at least once an hour. Other facilities will probably not use this standard. You may want to clarify this up front.
Who do you have to call to find out anything about the patient’s care?
Most facilities want to communicate with one primary family member regarding anything pertaining to the patient’s care. You may want to consider who that person should be before admitting or transferring the patient to any facility.
What activities will the patient be involved in during their stay?
Most extended care or rehab facilities will go over these items upon admission or transfer. You might want to know what your patient or loved one will want to be involved with.
What precautions are being taken for Covid patients or employees
In today’s environment, this is a prime consideration and the facility should outline this in detail to you. Elderly patients must be especially careful as many facilities have to provide special isolation procedures should someone inside be tested positive.
Will the patient have access to a phone whenever needed?
Every facility has different procedures when it comes to availability and utilization of phones for communication. Some facilities may have phones available and some facilities may have specific procedures regarding using personal mobile phones.
Is there a Chaplain available to the patient?
Many patients find this to be a prime consideration and might want to know what pastoral care is available at the facility or what process is in place to have their own preference of chaplaincy visit them.
How many Medicare days will the patient have left to cover expenses before they have to pay out of pocket?
For most extended care facilities, there is a policy in place as to how this may work and is normally communicate to the guarantor of the care expenses at the outset.
Do you have a Medical Director on staff that makes rounds on all patients?
It would be helpful for you to know who the Medical Director of the facility is and if they oversee all patient care delivery there. Also, how will this physician relate to the other physicians who are overseeing the care of this patient.
Can other care givers or aides be brought in to sit with the patient during the day?
This is an important question to ask because you may want someone sitting with the patient at certain times. The facility care givers or family members and visitors cannot always be with the patient in their room at an extended care facility 24 hours. The patient or the family might someone else to be available.
Coming in 2025
The Release of"The Hospital Guide for the Empowered Consumer" Written by Dr. Ian McFadden
Questions and Answers on how to handle a potential visit to the Hospital’s Emergency Room (ER) or Emergency Department (ED)
Is it necessary to go to the Hospital’s ER for treatment
At the time of any onset of an illness or injury, it may seem that the best alternative is to go straight to the local Hospital’s ER for treatment. Perhaps it is or maybe a trip to an urgent care center or the physician’s office the next day might be more appropriate. It all depends on how serious the illness or injury might be and does it require immediate treatment.
Can the Hospital Emergency Department that you select handle your illness?
Most Emergency Departments are able to treat most minor issues regardless of their size and should be able to provide the necessary testing to diagnose your problem. It is best to go to the nearest one even if it is smaller. It doesn’t have to be a Trauma Center although Trauma Centers are better equipped to handle very serious issues. It might be helpful to conduct some research on the particular hospital that you may be using before you are ever in need of using the ER. The Hospital’s website can provide helpful information as to what capability the Hospital has for emergency services. If you have to be taken by ambulance, the EMS personnel will be helpful in advising which Hospital ER is suitable for your condition. Finally, do your research on the Hospital’s Emergency Services by reviewing Google and Yelp ratings and other rating agencies such as Healthgrades, Leapfrog or CMS (HCAPHS).
If the issue is not that serious should you consider an Urgent Care Center or wait to see a physician?
This is a subjective question, but it does deserve some consideration. If the issue is not that serious and you have the ability to wait, it might be better to seek an Urgent Care Center which can process you much more quickly or perhaps wait to see your local physician if you are able to wait for a physician office visit. Depending on your condition, a typical Hospital ER visit can take up to several hours. Urgent Care Centers usually process any diagnosis and treatment in a much shorter time frame but there are limitations as to what can be treated there.
What type of practitioners are staffing the ER?
Most capable ERs should have at least one ER Physician on staff and in the department there 24 hours. Some ERs may also use Nurse practitioners or Physician Assistants as supplemental staffing in addition to also having Nurses in the ER with Advance Life Support certifications. If this type of personnel is not available, you may want to consider another option for your emergency issue..
What 24 hour diagnostic services are available in the Hospital for the Emergency Department to use?
A well established and capable Hospital Emergency Department should have 24 hour/7day per week diagnostic capability including the ability to have an MRI, CT Scanning, and Ultrasound testing performed at any time as well as the ability to have basic laboratory testing performed with the results returned within a 2 to 3 hour time frame. You should not have to wait an additional day or have these tests performed at a later time.
How fast should I expect the treatment or processing of my emergency care to take? How long will I be waiting
Be prepared to wait several minutes or longer in the waiting area until you can be “triaged” or prioritized for treatment and then placed in a treatment area or ED bed. The waiting time in the ER waiting area may depend on how busy the ED is and how serious your condition may be. For most significant emergency cases, it will then take at least a few hours for all testing and examinations to be performed before a decision is made concerning your status and a plan is developed for the next step in your care or treatment. This is especially true if your diagnosis depends on reports from the Radiology, Respiratory/EKG and Laboratory departments being returned to the ER Physician. Delays may also occur if the ER Physician has to consult with another physician or specialist regarding your condition and any findings.
If you have a personal Primary Care Physician, should they b notified?
Yes. Normally, the ED Physician or Staff will ask you if you have a personal physician and may contact them during your visit or you may wish to inform the personal physician yourself. You should also be able to tell the ER Staff all about the medications that you may be taking and any type of treatment that you may be undertaking under a physician’s care or supervision.
What about supplying insurance and billing information?
The Hospital will obtain this information from you upon entering the hospital or may even obtain it while you are in the treatment area and conduct bedside registration. It might be helpful to remember to have insurance information with you or with whoever might be accompanying you.
How often should the Physician and Staff check on me while I am in the treatment area.
Depending on your condition, a physician or nurse should in most cases be updating you at least every 30 minutes to keep you informed of the progress being made with obtaining reports on testing and exams. They should also inform you if they are collaborating with any other physician or specialist regarding your treatment and let you know if other physicians may need to see you. The determination of each step should be clearly communicated to you and you should know beforehand if you will be admitted to the hospital, discharged home or even transferred to another facility. If you are being admitted, you should be informed as to how long it will take to get you admitted and placed in a bed on another unit or floor and how long you will have to remain in the ED until you are placed.
What should I expect at the end of the ER visit?
You should expect to receive answers and enough information to fully understand the treatment plan and the next steps in the process whether or not you are being admitted, transferred or discharged home. Your ED discharge instructions should clearly outline the follow up process with future exams, testing or physician follow up appointments. You should also receive a list of medications and any prescriptions with instructions on how and when to take the medications prescribed. Make sure that someone transports you home if you are discharged. You will also likely receive a survey requesting you to provide feedback on your visit.