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2 weeks ago, an ambulance took my mom to the ER with severe back pain. Radiology showed multiple spine fractures and she was sent from ER straight to the rehab center.


The ER doctor mentioned that reconstructive surgery could be an option. I made an appointment with a neurosurgeon (for evaluation and suggestions for long-term care); he requested an MRI as a pre-requisite to the visit. Her primary care physician ordered the MRI and I made an appointment.


The rehab center will not allow her to leave for the 3 hours needed for the MRI ("her care should not be interrupted") and, since the ER suggested, but not actually prescribed the MRI or the neuro visit, it is not "immediately" necessary and the appointments should be cancelled and re-scheduled after her future discharge from rehab. Is this at all reasonable or legal? After her discharge it will take weeks just to re-schedule the appointments.


I am trying to contact the ER hospital patient advocate to discuss the time limits that the hours spent in ER should have on her care weeks and months later - nobody picks up the phone, no call back yet...

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So, if she has spine fractures, what is rehab doing? My Mom fractured her L1 in a fall. She immediately had a procedure done that cements the fracture which helps with the pain. Time heals it. Mom had 2 weeks of home therapy, basically to show her how to get around with a walker and how to sit in a chair to help in the healing process. What to do and not to do. She never had therapy even after the healing.

I think you need to get the doctor who is ordering these tests to contact the doctor at the Rehab. You can have Mom removed from the Rehab. They are not prisons. Never heard of a Rehab not allowing testing.
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I would contact the neurosurgeon and the PCP to raise the timing issue with them, as well as the issue of how rehab could help or hinder the situation. They're the ones who could opine more specifically on the need for an MRI now as opposed to later.

Another issue would be whether or not she would get rehab again after the surgery.

If the doctors agree that the surgery could benefit from rehab BEFORE discharge from rehab, I wouldn't wait until then. Ask the doctors to determine when rehab would end, and they can schedule the surgery NOW for that time period (unless it's also recommended that home therapy continue) after discharge from rehab.
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I suggest that the ordering MD call the rehab doctor.
When your LO is in rehab there is a whole separate doctor doing the care and ordering.
I would also speak to the rehab SOCIAL WORKER, your best friend in such an instance.
I find this extremely "unusual" let us say, as an RN. If this is a diagnostic test it could well be important and the results of the MRI could impact rehab.
My brother, in rehab, had to have a followup MRI one month in as regarded a thought to be (but not certainly) dormant, benign, old and calcified brain tumor that may have affected his balancce (a toss up as he also had Lewy's which affects balance). The doctors coordinated, and the social worker kept my bro in rehab three days longer with a trumped up "wound care excuse" so that the MRI could be done from the rehab, and the results known before discharge.
I surely do wish you good luck. Throw yourself upon the mercy of all three of those entities, ordering MD and rehab MD as well as Social Worker TODAY. Hope you will update us.
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Here's what I ran into when my dad was in rehab.

He is here for a specific medical need, if you take him out, he no longer meets the criteria for Medicare to pay. Because if he is well enough to go out, he is well enough to go home.

That makes loads of sense but, it is a pain when you are trying to move things forward.

Get with the discharge planner and find out what they are doing and when she is scheduled to be released. They start planning this the 1st few hours of admission, so they can give you a time frame. Then reschedule the MRI for that day or the next.

Best of luck, dealing with the medical industry nowadays is an exercise in frustration.
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Nurses and SWs do not make decisions regarding people in rehab. There must be a doctor overseeing your Moms care. That doctor gives the orders that the nurses are to go by. There is a doctor of record and Mom has a right to know who it is.

At this point you need a State Ombudsman to look into this. I may even call Medicare. And, I would question if Mom should even be in therapy. I may get her out and not return her. Don't let them say insurance won't pay, they will.
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I do not have any contact/ knowledge of any physician at the center. Both the social worker and the nurse have stated multiple times what I had described above - no immediate need, with complete lack of concern that this needs to be done so her care can be continued uninterrupted after they discharge her from rehab.

Her physician asked for them to call him to discuss, they did not. The only contact info I can give him is her social worker. (I will ask him again to intervene).

This is happening in NY state. Does anyone know where I can find a professional patient advocate?
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AlvaDeer Jul 2022
I am so sorry that they are not listening to you, and I cannot imagine why they are not. I sure wish I could guide you to someone that can help you, and I have no idea where to direct you in NY State. I hope that others do, or that your MD makes headway here. If not, you have tried everything and looks like this may have to be done, if it is not an emergency test, as an outpatient. Good luck.
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Getting in touch with anyone in the ER is difficult these days. I agree that having the MD ordering the MRI contact the MD at the Rehab is a good starting point (although everything seems to take forever these days and everyone and everything is understaffed). Were you present during your Mom's admission to the Rehab Center? If so, see if you can grab the Admissions Director or the short-term rehab social worker if they have one. If necessary, you may be able to get some clarification from the NYS Office on Aging... I don't think the Ombudsman's office would be of help as I believe they concentrate on long term care residents.
So sorry you are going through this, and I wish you the best of luck!
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Some good recommendations here. I also suggest you carefully read the paperwork that you or your mother received on admission to rehab. This would be a form of agreement or contract that should establish what the facility is required to do or not do. And I know it's like sending you down a rabbit hole, but you can also check with federal and state entities that regulate rehabilitation facilities. It would be helpful to know what rules the rehab center has to follow.
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Thank you all :)
In response to some of the suggestions: We did not receive any paperwork at all at her discharge from ER, it was handed in to the nursing home. My mom's back became progressively worse during the past years, currently at almost 45 degree angle, an intervention seems really necessary

I emailed the nursing home asking them to confirm in writing that the MRI and Neurosurgeon appointments should be cancelled (it is a big responsibility and I would rather have those recommendations in writing rather than by phone conversations). I have not received a reply.

Coincidentally, the day before the MRI, she tested positive for Covid by rapid test. I said: "I might be cancelling the MRI based on a false positive. Could you confirm the result?" No confirmation testing will be done (not rapid, not PCR) ever, because it is not required by NYS! (and God forbid anyone would do anything other than the minimum requirement). They will keep rapid testing every 3 days. So.
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AlvaDeer Jul 2022
So sorry to hear Mom has Covid. Are you closeby? Every three days sounds like a good protocol. So looks like test is delayed in any case? More worrisome is hoping Mom has a quick and certain recovery. Hoping you will soon update us that Mom is doing great.
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