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A friend has been in a rehab facility for nearly two weeks. No discussion yet on what's expected of her care. She hasn't received PT (someone helpfully brought up a sheet of exercises she could do in bed) and just started OT, apparently also in her bed.



I keep pressing my friend's husband to ask for one. He's been busy putting out fires - they let her glucose drop dangerously low, only monitoring her once a day, the onsite dialysis center flubbed transporting her to vascular access... Today he says the dialysis center director told him he was running ahead, rushing ahead instead of waiting for them to get to know the patient (SMH LOL SERIOUSLY??)



I thought the POINT of a care conference was to get to know the patient and discuss a plan of action for their stay.

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Uh-uh. If someone brought a sheet of exercises then she has seen a PT - it's the PT who prescribes the appropriate exercises. So either that or the someone needs his/her ears boxed. Are you sure the husband isn't pretty overwhelmed by everything that's going on? - in which case, you might want to dial back hard on pressing him to do more.

We get the hospital discharge recommendations. We get sight of the hospital discharge summary (if we're lucky). We then do our own assessment, and write the support plan which is reviewed - in theory - twice a week.

Trust me, there is a care plan in place because everyone who comes into contact with your friend is working to it. But it isn't necessarily in a presentable or long-term format, and more to the point if your friend is not medically stable then the care plan has to remain a work in progress until she is.

What took her to rehab?
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Are you saying that your friend is in this SNF for REHAB purposes, not there permanently, and hasn't had ANY PT/OT in TWO WEEKS? If so, it's time to get her OUT of there NOW and into another SNF for some REAL rehab immediately. That is to say IF she is in a condition that supports PT/OT and not too frail or sickly to be able to do any PT/OT. You don't say.

My mother was sent to a dreadful SNF for 'rehab' once in 2019 and had no PT or OT for over a week plus her care was outrageously horrible; her oxygen cannula was hanging in the air and hooked up to NOTHING, for one! I had a fit and went out looking for a better SNF myself, found one, and had the admissions director help me get the Medicare secondary insurance company to approve the transfer. The new SNF sent a mini van out to the SNF-from-hell to pick mom up and get her over to the new place where the red carpet was rolled out for her right away. She immediately got PT & OT for the remainder of the 21 day stay that Medicare pays for.

If your friend has been in rehab for 2 weeks with no PT, she's only got 7 days left before her time is officially over according to Medicare (unless she's approved for 100 days). Occupational therapy does not occur 'in bed'.........real OT is therapy that is taught to a patient on how to function outside of the hospital or SNF once they get home; like in the bathroom or the kitchen, etc. How does OT 'occur in BED' exactly???

This woman and her DH will be lucky if this SNF doesn't kill your friend before it's all said and done, by letting her glucose drop so low and ignoring her need for dialysis, etc. It sounds like a great place to get OUT of, imo. Her DH needs to speak to the admin immediately to see exactly what's going on here, what her care plan is, and go from there. To be in 'rehab' for 2 weeks with nothing happening is ludicrous, in my mind.

Best of luck.
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When in Rehab there should be a care meeting within 7 days. In none of the Rehab or NH care meetings was the doctor there. It was the SW, DON?, physical therapist and the nurse who coordinated everything who I never saw again. The meeting was only them telling me what was going on. Gave me a list of meds where I found out Mom was not receiving her Thyroid meds. Long story, turned out a Hospital Dr thought he could override Moms Specialist. (A pet peeve of mine) she was there 2 wks before I got a conference.

Yes, there is a problem if she has not started PT. OT are they teaching her how to get out of bed safely? OTs job is to help with ADLs. Her husband needs to ask the Director of Nursing why his wife has not started therapy. They are wasting her 20days that Medicare pays 100%. After that DH may be responsible for 50% that Medicare does not pay for the 21 to 100 days.

Rehabs are not skilled nursing. I am not a diabetic but I thought diabetics checked their levels more than 1x a day. I would say to transfer her.
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If the poor husband is putting out fires he probably is overwhelmed and might not be fully aware of the facts.

Can you go with him and be a set of ears? That's what I recommend.
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Uh, yeah, that should be a thing in the first day or two. I assume there are doctor's orders for all that, so there's no need to get to know her first. This isn't a sorority rush party, for crying out loud.

Has the huspand spoken to her doctor? He also needs to talk to the head administrator there and TELL them -- not ask -- what time he'll be there for his meeting.
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We had them like clockwork every three months. The administrator and director of nursing should be made aware of concerns
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