How do you discharge a patient from a nursing home?

If you want to take her home, yes, you can. You could ask for the NH visiting physician to script for home care, and after a few weeks' hospitalization that might be a good idea. But absolutely do your research on home care companies, interview their marketing reps (many now have them), ask questions, and be there for the first few visits of everyone.

If you feel she needs additional care at a good facility, ask one of her doctors about writing a script for continuing care, post hospitalization, on the basis of (a) loss of bed at the former nursing home, and (b) unsatisfactory situations at the existing one.

Check out my answer on this thread:

https://www.agingcare.com/questions/transfer-to-another-rehab-facility-215614.htm

That's how I handled a change of facilities, based on advice from one of my father's treating doctors.

The issue might be that if she comes home now, will she be able to recover well w/o home care, so consider that, and get a script either from the existing place or your mother's doctor for home care if you want to take that route.

The doctor at the unsatisfactory facility would be the one to discharge your mother, but you can work with the social worker to get to that point. You don't have to provide a reason for the discharge; just calmly and politely advise the DON or Administrator or doctor that you've decided to make a change in your mother's placement.

And when's she's safely out of there, contact the state ombudsperson and share your experiences with this place.

BTW, did the discharge planner at the hospital ask YOU for your opinion of which replacement facility appealed to you? If not, he/she should have.

When your mom lost her bed at the first nursing home, didn’t they offer to have her room with someone until a bed freed up? This happened with both my mom and my husband. It’s wasn’t a happy decision for either one of them, but my mom had to be in a facility, and my husband’s Medicare ran out but he wasn’t ready to come home from therapy yet. I am surprised that they didn’t offer you that option. Did you have a say in her going where she is now? Who made that decision? We’re you informed of the transfer? Did you approve the transfer?

If you take your mom out of this NH, do you have plans where she will go? I remember your writing that she’s combative. I’d have to say it wouldn’t be a good idea for her to come live with you, would it? As far as getting her discharged, just tell the Social worker at the home that you’re taking her out. She’s not being held prisoner there. Do you have either POA or guardianship? That would make it easier.

Plan how you will do this and what you’re going to do before you do it. That will make it easier on both of you.

No she just put her there no the case  manager just placed her and I disapproved but because I don't have poa I couldn't change it she said 

No they just didn't take her back

I walked into her room today and she was soaked not changed no water I cried..if they cannot place her tomorrow I am taking her home until I can get her in a better place..I'm calling her Medicaid social worker that she had at home tomorrow to see if I can get her home health hours restated....

I didn't approve the transfer to this facility but because I don't have power of attorney she didn't care

I am contacting a elder Law attorney Tommrow Andi wasn’t given a choice itold then I didn’t want her to go,there and they said because ididn’t have Positive can’t make that choice ,,iI told her to check places near my home and gave her names and she called and said nope no beds , I told her that ididn’t want Mom to go there but she said she’s being picked up tonight ...I felt I had no choice to send her there

I'm sorry that my edits came out wrong then I for some reason didn't come out

Meowzer, please don't worry about edits. I'm just sorry that you're getting such poor cooperation. And I think the discharge planner was "jerking you around."

I sure hope you have a restful night; this has got to be such so traumatic for you.

I've only shown my DPOA once, and that was over a decade ago when Dad was going to be intubated. NEVER have I actually had to present it when making decisions for placement.

Perhaps our hospital is more flexible, perhaps it's because I'm the only close relative and we've been there so much some of the staff recognize us. Or perhaps it's because I can haul myself up and stand rigid like a solider and be forceful when I need to be, and start talking legal speak if someone challenges me. And I've had to do that a few times. People back down quickly when I get in a legal speak mode!

I think your plan to take her home while you work things out might be the best, even with her physical limitations. And I really hope your Medicaid social workers comes through for you - you need a break!

Rest peacefully tonight, and think of Scarlet O'Hara's words when she despairs after Rhett Butler has walked out on her: "tomorrow IS another day!" And I hope it will be for you as well.

I'm traumatized completely and worried sick