Mom broke her hip. How do we find a good SNF for her recovery? - AgingCare.com

Mom broke her hip. How do we find a good SNF for her recovery?

Follow
Share

She is 88 and had surgery to replace the ball part of the bone that had broken off. The surgery was yesterday (the break occurred the evening before.) She still seems confused and out of sorts from the anesthesia. She had also broken her fibula three weeks ago. Left leg and right hip. Not a good situation! She will have to go to a SNF when she leaves the hospital. How do we find a good one? The ones I have researched online get HORRIBLE reviews! Anyone have any recommendations for facilities in the Dallas/Ft. Worth area? I am worried and concerned for her recovery.

17

Answers

Show:
GardenArtist, group therapy is indeed a group seated in chairs in a circle. Each could have a different reason for being in rehab. The “exercises” are simple arm movements sometimes holding weights. There is also a social aspect to it with the Occupational Therapist asking each group member a question while batting a balloon to them. The patient answers the question (ie What is your favorite holiday?) while batting the balloon back. OT does the first half hour then PT works legs for the rest of the hour.

Mom then has one hour of physical therapy one-on-one and an hour of occupational therapy also one-on-one. The sessions are spread out with a break for lunch between. No therapy on weekends unless you did not get 15 hours during the 5 previous days. She also has the same therapists every day which is great.

The facility is called a “Rehabilitation Hospital”. Nobody lives here. It is solely rehab.
Helpful Answer (0)
Reply to texasrdr22
Report

Texas, I've never heard of "Group" therapy. I assume patients do specific exercises all together in a group, rather than individually? Could be very helpful as individuals know they're not alone.

All the rehab therapy I've seen has been one to one, therapist to patient.

Since your mother's not in a SNF, what kind of facility is she in? Is it solely dedicated to rehab, something like some of the Medilodge facilities?

I'm glad to read of the great report of your mother's progress though - that's wonderful!
Helpful Answer (0)
Reply to GardenArtist
Report

Mom was finally released from the hospital and the denial for acute rehab care was overturned as a result of my formal appeal. She has now been in the rehab facility for 8 days and is amazing me every day with her progress! She is standing and walking with a walker, learning to use tools to dress herself as long as the "hip precautions" are in place (not bending, twisting, crossing legs, etc). She is scheduled for 3 hours of therapy a day with Group, Occupational and Physical therapies. She must do 15 hours per week. So far, so good! The other day she walked 167 feet at one time which exceeded the established goal for her set by the PT group.

I stay with Mom at night and once the Physical Therapist trained me to help Mom with transfer to the toilet, my life got easier since I did not have to wait for a tech to show up to take Mom. Most times it took so long that Mom could not wait. Mom does all the work with the transfer and I am there just in case something were to happen. So far so good! I am so glad I fought to get her into this facility and not a SNF. This facility is in the top 1% in the nation for their success rate in returning patients to the community. We want Mom to be able to bathe, dress and toilet herself again just like she was before the broken fibula and broken hip. She is getting there!

I am getting proper grab bars installed in preparation for her to come home. They have a tentative discharge date of 5/19 (coincidentally the exact number of days Medicare/insurance covers!)
Helpful Answer (2)
Reply to texasrdr22
Report

Take a breath. I have yet to read a GOOD online review for a SNF. As someone else said, most people who write a review are in a snit about something. The only way one can ensure good care and attention from a SNF is to be an INVOLVED family member who visits multiple times weekly (every day if possible and at different times so that the staff never knows when you are coming). Also, it may not be up to family to "choose" a SNF. When my relative who had dementia broke her knee, I visited some SNFs while she was in the hospital, but later discovered it was not my choice but was up to which facility would "take her" because of her limitations at being able to do the PT. So, she ended up at a facility that was 4 miles from my house. It was a bit shabby looking, but it worked out for the best as it was so close and I was able to visit daily.
Helpful Answer (0)
Reply to XenaJada
Report

At 9 days hospitalization, mom may have to be in rehab beyond the 21 days and she will be looking forward to payments of around $165 each day beyond up to 100 days. I am ignoring the info about hemoglobin and extended stay other than acknowledging that part which should be a separate question. It sounds like her body is shutting down. When considering rehab, make sure it is listed in her insurance plan. Out of pocket expenses could be $30 per day more if you are trying to choose something better. Also consider places that are close to home or your work because if you plan to visit every day, consider the mileage. You may want to bring her some of her clothes or personal items from her home. You can start packing that bag any time while she is still hospitalized.
Helpful Answer (0)
Reply to MACinCT
Report

Mom has now been in the hospital 9 days. After one unit of blood, her hemoglobin level is only 8 with no plans to give more. Concern about fluid overload is the reason the PA gives. Mom is not getting IV fluids and hardly drinks anything. I don’t doubt but what she is severely dehydrated.

After 3 different nurses stuck her far too many times, I insisted they get a PICC Nurse to put in the IV using sonogram guidance. It took an additional 15 hours for the PICC nurse to show up because someone did the order wrong. On top of that, the order for blood was cancelled because some staff member wrote in the notes that “the family does not want a transfusion”!!! What??? So screwed up.

We will hear the decision of the insurance company today regarding my appeal of the denial of acute rehab. Mom is running a fever today and that, coupled with the low hemoglobin is causing her to be even more lethargic. We may be here a while longer. Rehab will have to wait.

PS: Not sure why they give Mom a menu to order her meals. It is day 9 and on only one occasion has she received anything remotely close to what she ordered! And we are in a big city major hospital.
Helpful Answer (1)
Reply to texasrdr22
Report

texasrdr22, see my post on your question: "Rehab After Broken Hip" Asked by texasrdr22 about 2 hours ago 05/3/2018
Helpful Answer (0)
Reply to DeeAnna
Report

Why isn't the Social Worker helping to locate a rehab/nursing facility? Be aware, a broken hip is serious in the elderly. Mom may not be able to come home if she doesn't rehab well. Also be aware that Medicare only pays 100% the first 20 days, 21 to 100 only 50%. After 100days it's private pay or Medicaid if she has no money.
Helpful Answer (0)
Reply to JoAnn29
Report

Just for information in case anyone’s interested, here’s a list of the minimum staffing requirements by state. There are quite a few, surprisingly including NY which regulates every breath we take, that have “no minimum requirement” for CNAs. Michigan is 1:8 which is pretty good. Maybe we should move back.

http://theconsumervoice.org/uploads/files/issues/Harrington-state-staffing-table-2010.pdf
Helpful Answer (0)
Reply to rocketjcat
Report

Rocket, thanks for the compliment. I learned to make lists after going through some rough experiences and learning that the social workers/discharge planners at hospitals provide lists based on criteria that aren't always in a patient's best interest.

I thought there was a state minimum standard for ratios of patients to staff. There is in Michigan.

I also found that the best care was initially at a well run chain, but that deteriorated to the point that it didn't even meet basic standards. However, I found that a SNF founded by the Dominican Sisters of Peace was the best so far (other than one in Ann Arbor, but AA is a teaching hospital area and standards are higher all around.)

Sorry to learn you've had some bad experiences as well. I asked one SNF I interviewed 3 times before someone finally told me what the ratio was. When two people said that they "meet the minimum state requirements", red flags went up. And I was right - that was the place with the 1:14 ratio.


Rusbar, good idea to get information from someone who visits a lot of different SNFs and knows the good from the bad!


Texas, one thing concerns me, right now. That's that the IV was pulled out and apparently not put back in again. If she's dehydrated, she's not even going to feel up to thinking about recovering.

I would address, first the nurse, then the charge nurse, then the administrator, if that IV isn't put back in ASAP.

Even if she's taking fluids by mouth, she may have been getting antibiotics through the IV line.

My understanding is that if a floor nurse can't restart the IV, someone from Anesthesiology should be called to get one restarted. Make sure the staff knows you're on top of this; they really "dropped the ball" when my father was in last time.


As I think about all the issues with SNFs, I'm beginning to think a continuing ed course on selecting SNFs might be a good idea.
Helpful Answer (1)
Reply to GardenArtist
Report

Related
Questions