Knoxville Senior AdvisorWhat should we ask before a parent is discharged from a Knoxville hospital?
Ask whether your parent was admitted as an inpatient or kept under observation, how many inpatient days have been counted, what level of care the team recommends next, and what the plan is for medications, equipment and follow-up appointments.
The inpatient question decides whether Medicare will pay for a skilled nursing stay, which requires three inpatient days. The hospitals families in this region use most, among them The University of Tennessee Medical Center, Fort Sanders Regional, Parkwest, Turkey Creek, Tennova North Knoxville in Powell, Blount Memorial in Maryville, Methodist Medical Center in Oak Ridge, Fort Loudoun in Lenoir City, LeConte in Sevierville and Covenant Health Roane in Harriman, all have case managers who can answer it.
What are the options after a hospital stay in East Tennessee?
The usual options are going home with Medicare home health and private help, a short skilled nursing (rehab) stay, an inpatient rehabilitation hospital for intensive therapy, returning to or moving into assisted living, or hospice.
Inpatient rehab hospitals in the area include Patricia Neal Rehabilitation Hospital and Knoxville Rehabilitation Hospital. Most frail older adults go to nursing-home rehab instead. Ask the discharge planner for a list of homes with open beds, then check each one's CMS record on our nursing home list before choosing.
Can a parent go back to assisted living after the hospital?
Usually, if the ACLF agrees the new needs are within its license: Tennessee lets an ACLF keep a resident who needs tube feeding, suctioning or IV therapy for up to three 21-day periods, and keep someone at nursing-facility level of care with a physician's written certification.
Call the ACLF's director of nursing before discharge day, describe the new needs honestly, and ask for written confirmation that they will readmit. Arrange home health visits to the ACLF if therapy or wound care continues.
How do we pick a rehab nursing home quickly?
Narrow the hospital's list to homes certified for both Medicare and Medicaid near family, then compare CMS health inspection ratings, nurse staffing hours and the latest deficiency count, and call to confirm a bed.
If long-term care may follow, a home certified for TennCare avoids a second move later. Ask whether therapy is offered six or seven days a week.
Who can help us after discharge?
The ETHRA Area Agency on Aging and Disability (1-866-836-6678) screens for TennCare CHOICES and OPTIONS, the CAC Office on Aging (865-546-3500) helps Knox County residents with meals and services, and TN SHIP (1-877-801-0044) explains Medicare coverage.
A local senior living advisor can also check availability at assisted living communities while you handle the hospital. That help is free to families.
Side by side
| Discharge planners can | Discharge planners cannot | |
|---|---|---|
| Options | List rehab beds and home health agencies | Recommend one provider over another for you |
| Coverage | Tell you inpatient vs observation status | Change Medicare's three-day rule |
| Timing | Set the discharge date | Force you to accept an unsafe plan without appeal |
| Follow-up | Order equipment and home health | Arrange private hourly caregivers |
Sources: Tenn. Comp. R. & Regs. chapters 0720-26, 0720-21 and 0720-18; Health Facilities Commission, TennCare and Department of Disability and Aging pages; CareScout and VA rate tables, as cited above. See our editorial standards.
