How can we get Dad out of Insurance chosen B rated short term rehab into home care?

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How can we get Dad out of Insurance chosen B rated short term rehab into home care?

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Threatening extension and denial of home care. Dad had knee replacement surgery. He is 78, diabetic and obese, but hospital said he was ready to leave after 72 hours with own transport even though he could not stand.Had to pay for an ambulance. Then mom was informed the chosen planned ST rehab approval was reversed. Had to go with B rated place. When she asked to remove him, She was told it would be AMA and nothing else would be paid for. Everyone keeps telling her she is not talking to the right person.
Need info on his rights, and how to proceed to get him home with care.

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We were able to get him out with the aid of a state agency. It turns out most states have the equivalent of state social workers and patient advocates. In NJ it's 211, but your local library may be able to help you find one for your state if someone is in need. Thank you all for your help and best wishes.

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We got him released today. Thank you.

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My Mother was in rehab and she hated it. So I brought her home. She had physical therapy at home ,but it wasn't as intense as the physical therapy she was getting in rehab. She has never been able to straighten her knee fully which is exactly what the physical therapist in the rehab facility said would happen if she left early.

If I had to do it over again I would have made her stick it out two more weeks as recommended.

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Not all rehab facilities are alike. Some of them do a superb job and others don't. My husband had a severe stroke two years ago and after 3 weeks in ICU was transferred to the only rehab facility in our region that would take people with respiratory problems. He'd picked that up in the hospital. If this facility has a good reputation it didn't earn it with us. My husband was admitted to the rehab facility just before Christmas, (in fairness, probably one of the worst times for this to happen) and the covering doctor there told me that I should look for a skilled nursing home for him and palliative care. I was appalled that this judgment would be made before the facility had even begun to treat him, all the while when our alleged case manager was telling us what great things the facility did for its patients and the facility was running the clock on our private insurance. The case manager was never available when I could be there -- I was working full time while trying to manage this crisis and visiting the facility every evening -- and worse, almost never returned my phone calls. My husband spent all day in a room by himself because of the respiratory quarantine, and few if any of the therapies the case manager told us they would do ever happened. Staff, despite being told that my husband is hard of hearing, never made accommodations for that and deemed him unresponsive when he just couldn't hear what they were saying or was processing the information slowly at an early stage in his recovery. When he requested painkillers (he is not drug-seeking) it took at least 20 minutes for staff to respond. The only thing the facility did right was to refer us to a skilled nursing facility that turned out to be superb. He regained his left-side cognition there, relearned to walk there, and we still visit because we made friends there. Long story short, readers, please, please don't take referrals to facilities at face value. We didn't have that much of a choice, but many others probably do.

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Is Dad on Medicare?

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He is on Aetna Medicare, which we were told was part of the problem.

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I have several thoughts. Is he getting checked out by rehab's doctor? Is he doing physical therapy and occupational therapy at rehab? My father was recently in a short-term rehab. As he improved, all said he was ready to go home with home health care services. He was also released to his primary care physician whom he saw the same day he left rehab. What is the time frame that the short-term rehab is giving? If it is short-term, it should not last more than 10 - 30 days. How long has your father been there? The doctors/therapists should have an estimated timeline for his release.

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My mother was in rehab about two years ago after COPD exasperation and a hospital stay. She also hated the place. I went every evening and got her ready for bed and saw the disorganization of this place. After a week she felt much better and wanted to go home. I live next door to her and would take care of her. I went to the head of the rehab and told her my mom wanted to leave. She told me the therapist thought she should stay another week. I told this woman this is not the first time my mother had rehab after a COPD episode and I know she is ready. I was told I would have to have a meeting the next day to evaluate my mom's condition. I said " so in other words you have kidnapped my mother" I went to the meeting the next day and told three people there the same thing. She was released that day and was fine. She had a therapist come once a week for a month. Needless to say my mother will not be going back to that place!

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The HMO Medicare plans don't pay nearly as well. That's why we switched back to regular Medicare with a supplement. The HMO plans will usually only pay for a certain number of visits at home. For example, they may pay for only 25 visits total - including nurse, aide, physical therapy, occupational therapy, speech therapy, social worker, etc - no matter what is going on. So, depending on how many of these are needed at home, that doesn't leave very many visits for each type of help that comes out. With regular Medicare, a 2 month certification period is set up and within that time, each discipline puts in how many visits they think will be needed. As long as it's reasonable, it is usually approved. Medicare requires that they are homebound and continue to show some improvement steadily as you go along to keep paying. If the patient comes to a stand still and it is believed that that is as good as they are going to get, no matter where in the process or # of visits that were originally set up, it has to be stopped. On the flip side, if they are continuing to show some improvement up until that 2 months is over, and it is felt that they could get even better yet, the treatment can be extended. So, there's a lot more flexibility in treatment under regular Medicare. You might want to take this into consideration before they decide on which form to sign up with for the next year, during the open enrollment period which is going on now, if they haven't done so yet.

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Yes I had an experience with medicare, several years ago.
I used Wellcare part D to cover medication but when I went to
enroll in the extra savings that the Wellcare part A and B (in a whole covered plan)
were advertising to give me, (some Medicaid private insurances started a few years ago) and so much it covered, sounded good but the facility needs to take the plan.
I hurried and turned back to regular Medicaid and have been hassle-free ever since.

How can we get Dad out of Insurance chosen B rated short term rehab into home care?

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