DSHS wants me to say "yes" to an AFH that makes me nervous. Am I over worrying/thinking this?

Step dad was sent to a rehab facility after a hip replacement. The hospital social worker gave me the names of three that were close by. I checked all three and chose what I thought would be the best one. After the third night he was there I was making calls to get him into another facility, not the ones I had looked at.

Found out later the ones that I had checked based on SW recommendations were owned by a group of doctors. 😕 The place I moved him to was further away but a much better fair for his needs.

Thank you for asking this question. I wish I had known this 9 years ago when my.mom had her stroke. She was taken to the ER on a Thursday. On Fri, the SW said she was going to be transfered to a SNF on Mon. No list of places, just a phone call at 5:15pm saying the ambulance was on the way and I need to meet them at the SNF to admit her. Told the woman it would be nice to know the name and address of the place.

In answer to ur reply to me. A SW can help you find a bed in a NH but in my opinion, if you found a nice MC or AL by all means transport him. The SW is there to help not to force you to take what she feels is the right placement.

You know Dads finances. Go find a MC or AL. They will evaluate Dads care and determine if he is a good fit. Then you call the SW, thank her/him for their time but Dad will be transferred to an AL/MC of your choice. I have to agree with Cover99 here. This sounds weird to me that this SW is pushing for a NH when Dad seems to able to pay for MC.

When all is said and done, you make the decisions for Dad, not the SW. Be honest with the AL and MC concerning the care he needs. You can look for a nice NH.

From someone who has experienced this, don't trust the SW. As someone else mentioned, they usually provide you a list of places, you choose (usually 3), then the SW contacts them to see if there is an available bed.

Some SW also work for doctors, who not only are on staff at the hospital, but the NHs as well. These SW will try to steer you to a specific NH, (good or bad) where the doctor is on staff; this way he/she can bill for NH visits (usually NP visits in his/her place ) as well.

Woman tried to do this for my mom, even though the many of the places he was on staff at were lousy and low rated. This doc was not only on staff at the hospital but several NHs as well, so there was an incentive to get any patients needing this care to one of these facilities.

Like many others I'm seeing red flags all over this arrangement. A big one - you seem to be getting most of your information third hand filtered through the hospital SW. It doesn't matter whether this person is receiving kickbacks or is just overly controlling and zealous you need to ask your preferred choices to do their own intake assessment. And make sure that you are present and are given a copy of any documents submitted by the hospital so that you are certain the assessment is based on accurate information.

When I think of US elders (I am 80 next birthday) I think of our skin and bruising, and how quickly and easily we do bruise. I often have a quite dramatic bruise that I have NO idea how it got there until/unless I truly think it out. The most recent example is that I rode the bus home, having to stand, and leaned against a low divider with my lower shin against it as the bus started and stopped. I was using it for balance as I had a grocery bag with me. This dramatic bruise went ever shade in the universe and ended weeks later on a yellow brown note. Our flesh is very fragile. These bruises, when they occur in facility, MUST be reported. I would try to take that into consideration. I think that there must have been followup.
Hospitals and rehab facilities do not take and keep patients without acute care needs and rehab needs in our time.
There is no easy answer. I am 80. If I fall, I WILL bust something. As my balance is definitely not what it was when young, I WILL fall. These are the facts of life. That they haven't happened so far is purely luck.
I wish you the best in your decision. No easy and certain answer to our aging bodies. I still remember the day my 90s father reached down between the fridge and the cabinet for something that fell between them and came back with an arm absolutely STRIPPED of skin. We are, sadly, very fragile.

Whichever social worker told you that it's their job as opposed to yours could be (a) legitimate in his/her interpretation, (b) have an ulterior motive, especially as it comes to the particular place they're recommended, or (c) just controlling.

W/o intending to be blunt, you might want to consider that this could be a part of caring for someone, i.e., interacting with people who have their own agenda.

You wrote:

"... I was in talks with a memory care facility near by that has a good reputation, and would allow my father to have his own space like he wanted. The hospital/social worker nixed that stating that he's too cognitive to meet the requirement for memory care and would do best in an Adult Family Home.
So, I found an AFH that is nice, close by, and recently inspected with no deficiencies. The dshs social worker contacted the AFH and claimed they were looking for someone younger than my dad."

If this doesn't raise red flags, I don't know what will.   To me, this is an blatant attempt to manipulate you into allowing the SW to make the decisions.  Whether or not his/her preferred home is a good one, you WILL regret allowing the SW to make decisions for you.  You are ultimately responsible; take control, NOW.

Tell them no and call the facility that you wanted to find out why dad was nixed.

They could be, illegally, getting a finders fee from this facility and that is why the push.

I was given resources for facilities and that was the extent of the SW duties to help find a facility. Hospital and rehab facility both only offered resources for placement, not actual places.

Something is not right. Did the hospital get emergency guardianship for your dad? That would be the only situation that would make placement their job.

In regard to the hospital SW telling you it was her job to find or choose his place is incorrect. They supply you with a list that you can review but you most certainly can call others and ask them to submit to a specific place.

The new place can deny him - based on what the social worker and hospital have written and submitted in their care plan. You can also request them to come do their own assessment on him (some places do offer this -I’m not sure if all of them do). If you feel like the place you chose did not deny him then I would call back over to them.

Hospital SW or “case managers” work for the hospital - their job is to get you out and get you wherever there is an open bed so they do not get fined by Medicare for keeping you too long (basically). Now you do need to be proactive in finding other places that you would choose as a better fit (which it seems you have done) and those places can deny him if they feel they cannot provide the level of care that is written in his discharge care plan. So I would ask to review that care plan as well as reach back out to your first choice and ask if there is a specific part of his care they do not feel they offer or if they just don’t have a bed available yet - maybe something is incorrect in his discharge and they would be willing to accept him. But you have the right to choose the facility (but the facility has to be able to provide his level of care).
best of luck getting him where you feel he is a better fit. They don’t make it easy sometimes but don’t give up. 🤞🏼

Why was where u wanted him nixed? The only reason I see where they would be nixed is if a bed was not available or they didn't take Medicaid. You as the guardian pick where Dad goes not the SW. Tell the SW that you have done your research and you will not allow Dad to be transported to that NH. 2 years and COVID I doubt have changed the place.

I am with GA about maybe not trusting the SW. Her/his job is to get the patients discharged. They are not on ur side. And calling the facility is a waste of time, IMO, they of course will tell they have improved their care. Its their Administrators job to keep those beds full. Empty bed means money lost. Go with ur gut.

You could sweetly and gently come right out and ask the specific home operators how they've addressed these specific issues.  You have a right to know.  

I wouldn't necessarily trust or distrust the social worker, but I've found that hospital discharge workers (who I believe are social workers) aren't always honest or forthright.   They didn't tell us about a bad nursing home, continued to list it on their possible rehabs, but also acknowledged privately that another home has a reputation of people coming in for rehab, but not coming out except in a body bag. 

I would consider any SW advice with a grain of salt.  Do your own investigation.   I know from experience that they do try to steer people to some specific facilities.    After realizing that their actions are not impartial, I did my own investigations and just pretended to be interested in their opinions, sometimes b/c I suspected what they recommended was in fact not a good placement, so I knew to steer clear of it.

If someone was told that the operators "would try to do better", my response would be "you bloody well BETTER do better."    I think I'd keep looking, especially if this is a privately owned and operated home.  

Why did the homes that interested you get "nixed"?   Were there problems there as well?

And personally any home that's had those kinds of citations you describe would make me think twice.

I used to get a list from the Alzheimer's Assn., even though ALZ wasn't an issue with my parents.   The AAA also used to provide lists, but they never were prompt.

Would speaking to the people at the AFH home yourself relieve your concerns? That’s what I would do. If you don’t like their answers, say no. If it changes your mind, then try it.

All you can do is inform yourself as much as possible. I know rules are strict because of Covid, but can you go in for a visit? Talk to residents? What is the atmosphere like inside?

Inform yourself as much as you can, otherwise I don’t think you’ll be happy with whatever decision you make.