Does rehab discharge too quickly? - AgingCare.com

Does rehab discharge too quickly?

Follow
Share

When my father was recovering from his stroke in the hospital he was told of all the rehabilitation he would get for his left arm and left leg. This gave him hope because he lost most functionality with both limbs. The way the hospital social workers described the rehab he was led to believe they would help him until he was better. Unfortunately, that was not the case.

First he went to an in-patient rehabilitation facility. He made some progress but the staff was very conservative with his treatment. Occupational therapy tried to get him accustomed to day-to-day living. They helped him with transfers but did not try to exercise his hand much. The therapists had all kinds of advanced technology they could have used but decided to leave behind. Physical therapy was a little more helpful; they tried to assist him with a walker. However, just as my father started to show signs of making progress he was promptly discharged.

He then started in-home therapy. That lasted for a few months. The occupational and physical therapists told him he made some progress, but there wasn't much more they could do in a home setting. What next? He was always told he could go for outpatient therapy. But when the time came for him to get the outpatient care that he was told he would get, he was denied further therapy unless he experienced progress on his own.

This was disappointing because he made progress while in rehabilitation. He never got the chance to attend an outpatient center or use the modern-day technology that could have helped his hand.

Has anyone else had a similar experience? It feels like therapists, rehab centers, and insurance companies get to decide whether or not patients regain functionality in their arms and legs. These decisions have profound effects on families and finances. What are your thoughts?

This question has been closed for answers. Ask a New Question.
21

Answers

Show:
1 2 3
MaggieMarshall: I must disagree. The rehab unit of the NH my late mother was in told her "you're too well to stay here." They were DEAD wrong; she suffered a stroke there less than 48 hours after that statement.
Helpful Answer (0)
Report

For help, go to: http://www.medicareadvocacy.org/wp-content/uploads/2014/01/Jimmo-Postcard-General.pdf
Helpful Answer (1)
Report

"On January 24, 2013, the U. S. District Court for the District of Vermont approved a settlement agreement in the case of Jimmo v. Sebelius, in which the plaintiffs alleged that Medicare contractors were inappropriately applying an “Improvement Standard” in making claims determinations for Medicare coverage involving skilled care (e.g., the skilled nursing facility (SNF), home health (HH), and outpatient therapy (OPT) benefits).”

https://www.cms.gov/medicare/medicare-fee-for-service-payment/SNFPPS/downloads/jimmo-factsheet.pdf
Helpful Answer (1)
Report

Read Jimmo case from 2013. The "progress" criterion noted above was held to be illegal and improper. The case was reviewed in 2016 and Medicare is too put forth a better effort to make certain that contractors, providers and reviewers understand that the criterion is "need for skilled services" NOT "progress" potential or perfomance. Many Medicare recipients are not receiving the care they need. "Coverage for such skilled therapy services does not turn on the presence or absence of a beneficiary’s potential for improvement from therapy services, but rather on the beneficiary’s need for skilled care. Therapy services are considered skilled when they are so inherently complex that they can be safely and effectively performed only by, or under the supervision of, a qualified therapist. (See 42CFR §409.32) These skilled services may be necessary to improve the patient’s current condition, to maintain the patient’s current condition, or to prevent or slow further deterioration of the patient’s condition.” Sec. 30.4 of Chapter 8 of the Medicare Manual as amended in January 2014.
Helpful Answer (1)
Report

I think many people don't understand how rehab works. Rehab facilities are very happy to rehab patients as long as possible. They'll generally give a rehab patient three rehabs a day...physical,occupational and speech...the "speech" seemingly whether or not it was necessary. (I'm relating my mom's experience in rehab as WELL as all the other patients at the rehab unit.) Rehab is a lucrative service for rhem.

BUT a patient must absolutely continue to show progress. The therapists keep painstaking records. Unless a therapist is willing to actually lie? Patients will most certainly be discharged when they peak. At least in mom's case, Medicare continued to pay for at-home rehab 2 or 3 times a. Week, but this is nowhere near as effective as inpatient.
Helpful Answer (0)
Report

Yes, ABSOLUTELY! My mom was in a rehab unit because of her many problems (largest one=living alone, legally blind, 94 to mention just a few and no, we weren't the bad guys-she was adamant). After 8-9 days in rehab unit of NH, they said "you're too well to stay here." A load of BS because less than 48 hrs after they told her that, she suffered a stroke. She deceased. While at the hospital, the NH called me and asked if I wanted to do a bed hold at the NH @ $410/day! I wanted to scream but didn't ARE YOU KIDDING ME?!
Helpful Answer (0)
Report

I am confused! Nowhere on the Medicare site does it say that Inpatient Rehab only covers 21 days. It says that the first 60 days of Inpatient care which can include the initial hospital stay and Inpatient Rehab are paid as follows: Days 1–60: $0 coinsurance for each benefit period. Medicare site says Skilled Nursing Facility coverage is paid 100% for the first 20 days and then Days 21–100: $157.50 coinsurance per day of each benefit period. Why can't a stroke patient stay in an IRF if they are are continuing to improve & have been hospitalized less than 60 days?
Helpful Answer (0)
Report

Stroke there.
Helpful Answer (0)
Report

Yes, rehabilitation releases too quickly. Westford House Nursing Home said my mother was too well to stay there. Less than 48 hours later after they told her that she suffered a
Helpful Answer (0)
Report

The government would, of course, like for people to pay for PT out of their own pocket. But it my experience that neither my mother or mother in law would do that. They very well could of, but refused.
Helpful Answer (0)
Report

1 2 3
This question has been closed for answers. Ask a New Question.
Related
Questions