My 82 year old mother broke her hip 5 weeks ago. Spent a week in the hospital after surgery and has been in rehab ever since. My mom is walking (mostly with a walker) and has climbed stairs and goes to the restroom on her own at rehab.
She lives at home with my dad. We want to have home care set up for her along with PT/OT.
Here’s the issue. The facility never set up a “care team” for her. There is no doctor assigned to her. No social worker for us to talk to. No one will answer our questions because they are “understaffed”. My mom is left in her room for days at a time without therapy or nurse check-ins where the only interaction is her 3 daily meal deliveries. She was brought there because it was the only place in the area with an available bed. My father is too soft spoken to demand answers and my mother is miserable. We called a home health company who told us they have to have a referral from her rehab doctor. My mom says she’s never been seen by a doctor at the facility. I’m not sure what to do! What are our rights? How do we get someone to give us the information we need?
Medicare only pays the first 20days 100%. Unless ur parents have a good suppliment they are now paying the 50% that Medicare isn't for 15 days @150 a day (maybe more). That is about $2250 they owe. Can they afford it. If not tell the billing office that your parents can't afford the extra days especially when getting nothing to show for it. Tell them you want her discharged and set up with a Homecare of your choice. If they don't do it, threaten to call Medicare or even Adult Protection Services, telling them they won't allow Mom to leave. Rehabs are not jails.
Rehab is a choice not a given. You can refuse it and choose in home or outpatient depending on what the person needs. My GF lost part of her leg from juvenile diabetes at 60. She did not want rehab and they could not force her. My Mom went after a 4 day stay in the hospital just for strengthening. I told them going in there was no money so she needed to be released by the 20 days. She was there 18. The PT said she would need assistance to walk even with her walker. Got her back to her AL and she was walking all over with her walker no assistance. She was miserable those 18 days and she had Dementia. She got PT maybe 2x a day the rest of the time she was in a wheelchair. I swore I would never put her in rehab again. Our rehabs are connected to LTC facilities that except Medicaid who does not pay what these facilities get privately. Money maker is rehab.
I don't think people in rehab for therapy see a doctor unless a problem arises. The Physical therapist and staff are the only people they see.
That generation doesn’t always like to rock the boat. So, your dad is most likely trying to be agreeable even though it is disturbing to him.
I know it’s difficult for you to see as well. I don’t blame you.
When my mom was in rehab it wasn’t a ‘hit or miss’ situation. They did their job! She had wonderful PT and OT. It was consistent care.
We have also had success with home health doing PT and OT.
Please follow up on what it will take to resolve this issue. Since this is happening with your mom, it’s also happening to others. That simply isn’t fair to the residents.
I’m so sorry that your family is in this situation.
Some home health companies have referral doctors of their own; the one you called may have that arrangement. But, better yet, contact the surgeon who performed the hip operation. And be candid but not critical about the situation, expressing concern that she's not only subject to non-progression, but of regressing b/c of the lack of therapy.
You might also raise with the surgeon (or more likely one of his staff) the fact that this was the only place with an open bed, and ask if consideration should be given to a more competently run rehab.
However, if she's already been there for 5 weeks, her Medicare (which I assume she has ) time may be running out. That might be something to verify fairly quickly, to ensure that she's not going to be switched to private pay status.
And given this apparently not good experience, planning for a home rehab would probably be better.
I don't know all the regs for rehab, but I can't help but wonder if a lack of an examining and treating physician might be in violation of one of their standards, and/or of Medicare's standards.
If it were me, I'd interview as many home care agencies as I can and be comfortable before you commit to one. I've had some really good ones, but one that was so bad I terminated them in the second week. And, ironically, it seemed to be one with a good reputation, but there was only one out of 3 or 4 therapists who was worthwhile.
Another consideration is removing your mother from the rehab for a "check-up" by her surgeon. When my father was in rehab for one of his 2 broken hips, I did make that kind of arrangement, as his surgeon wanted to check, for himself, what Dad's progress was.
I recall that we also did that for my mother, as part of negotiating more competent care at her rehab. Her surgeon was not satisfied with the rehab management's position and attitude, and wrote a letter to them. That straightened things out immediately.
You could also ask the surgeon to recommend a good home care agency, to be sure you really do find a reliable and reputable one.
Director of nursing? Administrator of the facility?
Could call and say you need her discharged ASAP.
Oh, call her regular doctor and maybe they can intervene on her behalf?
How crazy and frustrating, etc.
When my mom was recently in rehab during this covid stuff, it was hard to get info and she was basically ignored and just warehoused on weekends. I told the nurse on the weekend that I was picking her on Monday at 11 and that was that. You have to get really strong and demand assistance. Tell them you are calling the state, etc. Maybe that will get their butts in gear.
I always think that money is one of the motivators for them being uncooperative with a discharge. As long as the bills are getting paid, they're in no rush to discharge someone bringing in money.