Hi there, gonna try to keep this sweet and short.
My dad has recently become immobile, he was having a lot of trouble standing and bearing weight on one of his legs. We took him to the hospital and found out he has a DVT in his leg. He started medicine for it and was moved to an acute rehabilitation center for care and therapy. When he first got there they explained the process. She explained that once they come up with a discharge date we can accept it, appeal it or potentially have him sent to another center. They only gave him about 10 days of actual therapy and they want to discharge him this upcoming Wednesday (11/05). My dad has yet to walk and is just now improving on his ability to stand. We strongly feel like he would benefit from more physical therapy at a different facility. We have a meeting on Monday to discuss his discharge plans but as of right now the case worker said their plan is to discharge him to home and provide some type of in home therapy. Is there something we can do or say to advocate for my dad to push them to refer him to another center for more physical therapy? I realize they can only provide help for him for a short amount of time, but will they give us issues if we want him referred somewhere else to get more therapy to return home as strong as possible? He is fully insured with Medicare/Medicaid
It’s very highly unlikely we will be able to care for him at home safely until he is returned to his regular routine and mobility. We are just afraid they are going to try to send him home & that’s that. If there’s something you know we can do/say please give some type of advice 🥲
Age? Does he have dementia of any type? Other medical problems?
And the biggest one.
Did he improve during the days of rehab he had?
If he did not improve then Medicare will not pay for more rehab
If he has dementia of any type it is difficult for him to follow directions and to follow through with what they are asking him to do.
Does dad live alone? If so is it safe for him to return home and continue therapy at home as they plan? If he lives alone and it is not safe then you must tell them that. They can not discharge him to home if it is not safe. Period end of discussion.
If dad lives with you or other family member again if it is not safe they can not discharge him.
If dad is living in an AL facility and he can not walk he may not be able to return to that facility. Again it would be unsafe, the facility would not accept him back. (If they have to use equipment to move him or if he would be a 2 person transfer they might not be able to accommodate that) Most likely it would be a move to Skilled Nursing. And if he does have dementia possibly Memory Care if the facility can use equipment. (Most facilities can not use equipment that would be for Skilled Nursing and Rehab)
If he is safe at home, if he follows through with therapy instructions he may do well at home. It all depends on his motivation and ability to follow through. AND motivation and ability to follow through by family if he is living with family members. But that motivation and follow through takes time and effort and if you are working and raising a family you may not have time to devote to that.
How old is your Dad?
You posted this under Assisted Living but you make mention of him going home... where does he actually live?
What is the reason they wish to discharge him so soon? Is it because he's not progressing or not cooperating? Either of those 2 things will cause PT to be discontinued.
I don't think the rehab will care if he goes to another facility but the question is, will Medicaid pay for it because it is felt it will actually benefit him? If you Dad is fairly advanced in age (upper 80s, 90s) then the likelihood that he returns to his prior level of mobility/function is less likely (or more difficult to attain).
Maybe pick another rehab and ask these questions to them. If Medicaid doesn't think it is medically warranted, they won't cover it and therefore the rehab won't accept him as a patient.
Your Dad can find and privately pay a physical therapist. You need to feel certain he will do the exercises at home that are assigned (if any) or else it will all be for nothing.