I agree with Alva. You said in your profile that she came to rehab from assisted living. It is entirely possible that whatever reason took here there may prevent her from returning to an assisted living facility - or they do not think it is safe for her to return to a place where she does not have 24/7 attended care. It may be temporary until they feel that she is strong enough to go back. Or it may be a permanent situation where they are not releasing her because she is not in a suitable condition to return to live on her own, even with "assistance" that is not 24/7 and will need to step up to a skilled nursing facility.
You don't mention why she is in rehab. Can you share more about what happened?
You are concerned about the fact that you have not been included in the decisions about her care - and you mention that you placed her in Assisted Living. Do you have POA? Or does one of your siblings?
I'm guessing at 95 that the most likely scenario is that she fell and they took her to the hospital and from there she was transferred to the rehab facility to work on getting her strength back, perhaps had a UTI that contributed to thing and very well may STILL have that UTI, since you mention that she doesn't understand why she is there. If she does NOT have a UTI, and she is still confused about why she is there, I would be curious if there has been any deterioration in her mental capacity that you are not aware of. If you or one of your siblings has POA you should be able to get any detail that you wish from the rehab facility. And I would definitely raise the concern with the Assisted Facility that you were not contacted regarding the transfer when it occurred.
Why is Mom in Rehab? And why would she not understand why she is there?
Rehabs are not prisons. But they, by law, have to make "safe" discharges. Family may have to prove that safety measures are in place and care is being given especially if 24/7 care.
Yep, I learned this the hard way. My mom was transported home by ambulance and when they learned she did not have overnight care, they were going to turn around and bring her right back. I was 3000 miles away and had to arrange overnight coverage for several weeks while on the other line with the EMT before they would agree to let her stay at home.
when my husband was in rehab after back surgery, the covering doc would not let him out until his coverage ended. Hub & I wanted him out because they were drugging him & wouldn't tell me what they were giving him. I finally went to the surgeon who was able to override the presiding doc. The back surgery was early Dec 2019. Hub left rehab Jan 11 2020. We didn't know about Covid on that date, but if he had stayed until the end of February he might have never gotten out alive. I firmly believe that if you have a strong gut feeling, go with it with all you can.
As suggested by someone earlier... please remove your mother's name from your profile and never post details such as that online. It can set her up for being scammed. Identifying details are never a good idea nor necessary in public forums such as this.
This is tricky. The Rehab facility has a legal duty to ONLY discharge her to a "safe" environment and depending on her condition and where she'd be discharged to they may have determined it is NOT medically safe to do that, do allow such a discharge. You might want to discuss their reasoning and what if any accommodations would make a safe discharge. Do they want a hospital bed for her where she is going? Do they want day and night nursing? Are their IVs needed or oxygen; can that be safely arranged to where she'd be discharged. They need to tell you why it is "not safe" and what you need to do to make it "safe." Of course all those "what make is safe" things may NOT be covered by insurance; so you need to ask that too. If NOT covered by insurance; will you or your mom pay for that? If not, and then those extra necessary things are NOT provided the discharge remains unsafe.
But you can still pull her out if that is your and her decision. Paperwork would need to be signed by her that "she understands" the discharge is "against medical advice" and "she understands it is an unsafe discharge." They will want this to cut their liability if something bad happens following an unsafe discharge. If she signs such paperwork, there may be no legal remedy if something bad happens but that is her/your decisions.
Finally, also be aware that if one leaves the Rehab facility "against medical advice," then the bill for everything up to that point may NOT be covered by insurance! This happened to my cousin. He broke his back in two places and had surgical rods installed. Post op; he was moved to a Rehab facility where they were going to fit him with a back brace as well as do initial PT so he knew how to move -- or not move -- to protect his back while he healed. The Rebab stay was to be for about 7-10 days; but he discharged himself (against medical advice) the 2nd day there, hated it. He went home to no hospital med, no IV, no pain meds, no back brace. Had to call 911 the next day to take him back to the hospital because lacking the proper care the surgical wound opened back up and rods shifted and the surgery had to be redone. This time they kept him in the hospital for 6 days to get compliance, but the insurer decided to NOT pay the the Rebab facility bill nor some of the second go round with the second surgery.
All to say, make sure to check with her insurance as to what may or may not be covered/paid for expenses to date (or potential new expenses with the same medical issue) if she discharges herself "against medical advice."
I talked to a gal a Medicare,she said as far as they are concerned, as long as the preson was admitted, they would pay for their time there, they didn't care how they left. Of course, other insurers may feel different. then there is the thought that the gal I talked to didn't know what she was talking about.
I have in the past had rehabs been mad that we took mom home for home rehab after insurance coverage ended. Plus hospitals highly recommend as my mom got older to place her in rehab after a hospital stay. But I had a good relationship as well as my mom with a home physical therapist that I knew could get my mom moving quicker then then the hospital & rehab. Mom trusted her. Plus I had a fantastic young lady to help care for mom. Between the two of us we knew we had the skills needed. Plus we already had a hospital bed, wheelchair if needed, handrails etc. Plus when hospital PT thought she could not stand, because they would not use the same commands she was used too and would not let her put on her shoes, which I had told them earlier was needed. I showed the nurse when it was time to go home that I was able to safely guide my mom to a safe stand turn and sit in a wheelchair on her own. She was was totally shocked. He had been told by the hospital PT my mom was a three person transfer. The problem my husband and I found over the years with hospital and rehab is once your loved one reaches a certain age they do not have the expectation of a full recovery of their abilities. My mother in-law years before, the rehab only worked with sit and stand, nothing else and told us they were sending her home because she was not progressing. They were shocked when we told them that the night shift was failing to inform them that during the night she would get up in the middle of the night and walk to and from the bathroom herself. Her roommate validated this information. 97 and never used a walker . So sometimes these places do not always see everything your elder can do. Find out more information about what you need to do to make home safe.
Why was she taken from AL to rehab? Will she go back to AL after rehab? After rehab will she go to Skilled Nursing? Are you going to bring her home with you if she is discharged from rehab?
If she is going back to AL after rehab if the AL can not manage her needs they can refuse to allow her back as it is not safe.
If she is going to Skilled Nursing after rehab a facility with a bed has to be found before they can discharge her from rehab.
If you are going to bring her home with you do you have a place that is safe and will meet her needs?
Does mom have dementia? Is she cognizant? Who is POA for medical? This would be the person that should be making decisions for her and about her care. If no one is POA is anyone listed on her HIPAA forms as to be able to get information about her health?
A bit more info as to why mom is in rehab might help.
Renable us not a prison and they cannot hold her there if you want her home as long as you understand what her care needs are. My mother had been to rehab after a hospital stay for Covid and she did need rehab however right from the beginning there were so many problems with her care. First I found out they were not even bringing her a meal tray into her room, and I only found out because I was there at the time. I asked when she was to get her tray only to be told they were given out already. I had to get them to put her on a diet list and get her food, then it came as all puree. I asked why and they had no explanation so again I had to request regular food. Then I found out they were doing finger sticks on her about four to six times a day, again why? So they said because she's diabetic, and I had to get them to cancel that order because my mother has never been diabetic in her life. So between not getting food, unnecessary finger sticks I was peeved. My mother starting shutting down, barely speaking. Then I found out the actual physical therapy was only about an hour a day so I felt she could do better at home. I had to have a meeting with the team and they all tried to say it was unsafe for her to go home but I countered all their arguments by listing ALL the issues and the incorrect info they were basing her treatment on EVEN though I had done an intake assessment with the admitting doctor. I told them I had everything she needed for a safe transfer home and that the only thing I needed set up was at home physical therapy and transportation home. At the end they were still trying to make her stay but the tune changed when I told them I was a nurse and knew they couldn't keep her. I usually don't bash hospitals or rehab because I've worked on that side of it but I truly felt money was a driving force here as my mother has excellent insurance that covers a lot. Don't let anyone push you into what is not in the best interest of your loved one. Conversely be sure you have everything you need for care, and support of your loved one. Wishing you the best outcome.
Interesting question a rehab place pulled that on me with my wife. She was there for a broken wrist and rehab on her legs. They tried picking her up by her broken hand and re injured her wrist that required me to take her to the er. I wanted her out but they would not let me until her insurance ran out. Later I found out they can not do that legally. Lawsuit pending.
You can always discharge the person against Medical advice (AMA) but they will not give you prescriptions and I think a poster said if they go back to the hospital for the same thing they were taken out of rehab for, insurance may not pay.
For everyone's information, you can turn down rehab. Its not a given. When they called me at the hospital about discharging my Mom, I was told Mom was going to Rehab. I was not given the impression I had a choice just asked which Rehab did I want her to go to. You have a choice. Both my Dad and a friend of mine turned it down.
I was told by the RN at Moms AL that if your going to Rehab just to strengthen you, its 3 days of therapy for every day you were in the hospital. For Mom that should have been 9 days, she was discharged from Rehab after 18 days. I heard she could not take direction and could not remember her exercises from day to day. She had Dementia. I would have been better saying no to the Rehab and having Mom do therapy at the AL. I was told she would never walk unattended, within 24 hrs being back to the AL she was walking with a walker. So much for therapy.
You can take her home “against medical advice.” If you choose to do so, do it “amicably.” Arrange for in-home therapy to continue any recovery in-progress.
Before you do so, make sure your house is most importantly, safe (occupational therapists can help with this), properly equipped and you have backup for care giving (family and paid CNAs both are a good plan, if possible). You may not be able to safely leave your loved one at home alone, so get coverage arrangements in place. The rehab providers can always report you if they think your elder family member is not receiving appropriate care so tread gently and make sure you have everything ready.
momchavez13: I am unsure why your mother went to a rehabilitation facility from an assisted living. More information is needed. Also, you need to remove your mother's surname from your profile.
Need more information here, like LOTS more!
Is the rehab center saying that she could benefit from more time there? This isn’t unusual if they are.
Why is she in rehab? Tell us more, please.
You don't mention why she is in rehab. Can you share more about what happened?
You are concerned about the fact that you have not been included in the decisions about her care - and you mention that you placed her in Assisted Living. Do you have POA? Or does one of your siblings?
I'm guessing at 95 that the most likely scenario is that she fell and they took her to the hospital and from there she was transferred to the rehab facility to work on getting her strength back, perhaps had a UTI that contributed to thing and very well may STILL have that UTI, since you mention that she doesn't understand why she is there. If she does NOT have a UTI, and she is still confused about why she is there, I would be curious if there has been any deterioration in her mental capacity that you are not aware of. If you or one of your siblings has POA you should be able to get any detail that you wish from the rehab facility. And I would definitely raise the concern with the Assisted Facility that you were not contacted regarding the transfer when it occurred.
Rehabs are not prisons. But they, by law, have to make "safe" discharges. Family may have to prove that safety measures are in place and care is being given especially if 24/7 care.
But you can still pull her out if that is your and her decision. Paperwork would need to be signed by her that "she understands" the discharge is "against medical advice" and "she understands it is an unsafe discharge." They will want this to cut their liability if something bad happens following an unsafe discharge. If she signs such paperwork, there may be no legal remedy if something bad happens but that is her/your decisions.
Finally, also be aware that if one leaves the Rehab facility "against medical advice," then the bill for everything up to that point may NOT be covered by insurance! This happened to my cousin. He broke his back in two places and had surgical rods installed. Post op; he was moved to a Rehab facility where they were going to fit him with a back brace as well as do initial PT so he knew how to move -- or not move -- to protect his back while he healed. The Rebab stay was to be for about 7-10 days; but he discharged himself (against medical advice) the 2nd day there, hated it. He went home to no hospital med, no IV, no pain meds, no back brace. Had to call 911 the next day to take him back to the hospital because lacking the proper care the surgical wound opened back up and rods shifted and the surgery had to be redone. This time they kept him in the hospital for 6 days to get compliance, but the insurer decided to NOT pay the the Rebab facility bill nor some of the second go round with the second surgery.
All to say, make sure to check with her insurance as to what may or may not be covered/paid for expenses to date (or potential new expenses with the same medical issue) if she discharges herself "against medical advice."
Will she go back to AL after rehab?
After rehab will she go to Skilled Nursing?
Are you going to bring her home with you if she is discharged from rehab?
If she is going back to AL after rehab if the AL can not manage her needs they can refuse to allow her back as it is not safe.
If she is going to Skilled Nursing after rehab a facility with a bed has to be found before they can discharge her from rehab.
If you are going to bring her home with you do you have a place that is safe and will meet her needs?
Does mom have dementia? Is she cognizant?
Who is POA for medical? This would be the person that should be making decisions for her and about her care.
If no one is POA is anyone listed on her HIPAA forms as to be able to get information about her health?
A bit more info as to why mom is in rehab might help.
I was told by the RN at Moms AL that if your going to Rehab just to strengthen you, its 3 days of therapy for every day you were in the hospital. For Mom that should have been 9 days, she was discharged from Rehab after 18 days. I heard she could not take direction and could not remember her exercises from day to day. She had Dementia. I would have been better saying no to the Rehab and having Mom do therapy at the AL. I was told she would never walk unattended, within 24 hrs being back to the AL she was walking with a walker. So much for therapy.
Before you do so, make sure your house is most importantly, safe (occupational therapists can help with this), properly equipped and you have backup for care giving (family and paid CNAs both are a good plan, if possible). You may not be able to safely leave your loved one at home alone, so get coverage arrangements in place. The rehab providers can always report you if they think your elder family member is not receiving appropriate care so tread gently and make sure you have everything ready.