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

Is Dad on Medicare?

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

We got him released today. Thank you.

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.

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.

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.

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.

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!

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.

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.

Note: To Iwentanon: I think you mean Medicare, not Medicaid, don't you?

Yes I did mean medicare, my Thanksgiving was yesterday, I am a little tired today.

My comment was before the healthcare initiative, but I think that it is still valid.

About the rehab, I believe you would be talking with the social worker,
about those rights, if he cannot walk, how would he be able to go home
and how would he receive therapy?

Without therapy and someone to encourage his range of motion,
range of motion will be lost.

In Chicago I know he could receive care from the Rehabilitation of Chicago.
If the social worker isn't helping, then I would consult their boss or the administrator.

wellcare only offers 20 days of rehabilitation. if she remains longer she would have to pay $152.00 dollars daily. my mom has weak legs. can she sign her self out before the 21st day even if the doctor does not sign her release form? does wellcare require a signature or else we could end paying everything?

As far as my experiences with "rehab" goes I wish I never would have believed the medicare star rated system. These places are not a prison and they should let the patient go if they want! I sent Mom to a rehab facility that appeared clean, no smells, 5 star rating....and once she got in there the staff seemed hostile and just did not listen to any of my concerns about my Mom's uncharacteristic confusion...blowing it off to "sundowners" or dementia which Mom does NOT have! The physical therapist howled about my Mom's lack of progress, and they left her lying there and a stage IV bedsore occurred. I only found out about this bedsore from a hospital intake nurse when the facility doctor had Mom rushed into hospital with delirium from a UTI which was the reason for her confusion in the first place.They took a week to test for the UTI though I kept telling them this could be the problem. This bedsore resulted in osteomyelitis later requiring 6 weeks of hospital stay for IV therapy. After the delirium hospital stay they recommended "rehab" in another SNF. The physical therapists in the second facility were good, but any good they did was shot down by a lousy nursing staff and boldly lazy nurses aides...one who dropped Mom in front of her wheelchair causing a broken leg.....Yes...another 5 star rated facility. Mom is at home with us now and getting physical therapy here. I understand these nursing homes rate themselves....what nursing home would give themselves a bad rating?! I mean how would it be if teachers allowed their students to grade themselves??!! Just hearing the words "nursing home" or "rehab" sends me into angry anxiety state after these awful experiences. Those star ratings mean nothing to me anymore.