Surgeon and physical therapist okay'd release from rehab. Rehab says no. Can they truly keep her?

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A dear friend (71), who is in excellent health, broke her ankle and was sent to rehab by hospital. First, there are three rehab choices in this small rural town of 25K. Hospital would only send her to one place -- no discussion -- and it's the worst of the three by reputation in town. She has medicare and supplement.

After two weeks, PT said she had exceeded goal and she was OK'd to go home with boot and chair. Rehab admin said she could not leave until surgeon OK'd. Surgeon OKd release from rehab days after PT, reminding her to not put pressure on the ankle when home.

Admin at Rehab said "no" to release home, where there is a husband and adult son.

She's now been there five weeks. No one comes in to care for her as she needs no care. The only service she gets now from rehab is meals served. No nursing, no PT, no doctor visit...

Admin drove her to her home two days ago to inspect home for suitability for release. Admin said "no" ..home bathroom and one hallway is too small for her scooter. She said it was best she stay in rehab.

Friend is going nuts there.

Anyone experience something similar? Can they truly keep her there? So much for the USA and freedom!

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March into the administrator's office and tell him/her that if the patient is not delivered home properly within 24 hours that you will make sure they do not get paid by Medicare, that you will file a complaint with Medicare, and sue the facility if they try to bill the patient.
Patient must be home by now, right?
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GardenArtist, unless this town is back in the 1940's and still using party-line telephone service where noisy neighbors can listen in :)

I remember as a small child visiting my grandparents in the mid-west, the wall phone would ring but neither Grandma or Grand-Dad would answer it.... being a kid I had to ask.... well, it wasn't their *ring*.... eventually I learned which of all the rings was theirs :) Even the local grocery store had a special ring to all the houses so that the people could hear what were the current items on sale.
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FF, good point. This town almost sounds like the legendary Camelot - a community taking care of 2 men, cohesive, tight knit.

But I've been confused about something. Apparently the only permanent residents are the 400. The temporary residents are the students. But then I'm wondering about those figures - Sunshiney wrote that " It's a college town and when you remove the "kids," there's only about 4,000 people/adults left". Isn't that the reverse? With the "kids" wouldn't there be more than only the 400 permanent residents? But in the original post Sunshiney wrote:

"First, there are three rehab choices in this small rural town of 25K."

400, 4,000 or 25,000 residents? I must be having a "math moment". Am I missing something? Maybe I need more chocolate for brain food?

It certainly doesn't sound idyllic, though.

"There's a couple of attorneys in town that we could call. You have to remember that when you live in these small towns, everyone knows everyone and everyone's business, too. One phone call to an attorney will be known by the nursing home within an hour and I could guarantee that."

That's despicable, disgusting, and a violation of attorney client privilege. Any attorney who reveals privileged information needs to be reported to the state bar association.
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Sunshiney, whatever you do, do not move away from that town.... it is truly amazing that a town of 400 has a hospital plus 3 rehab facilities.

The small town my Dad grew up in out in the Midwest, similar size to yours doesn't even have an urgent care facility.
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Fourth sentence should read "this is 2015".... sorry for the omission. Computer gremlins are busy today.
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Flyer makes some good points which I hadn't considered. Between the husband and son, I would think they could make their own meals. And watering plants is pretty simple. The support of the community is wonderful, but this 2015 and men have become very self sufficient in meal prep and house management.

I'm wondering if this small community is one of the rural religious communities in which men and women have very defined roles, and the women are the caregivers. If so, that could be a reason why the husband and son haven't stepped up to challenge the nursing home.

Perhaps they're really not prepared mentally or physically to provide the care your friend needs.

That makes just as much sense as the nursing home admins having an ulterior motive.
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Sunshine, oh my gosh, you mean your friend's husband and son needed to be fed by a village of people, for the past 5 weeks if not more? Plus someone comes in twice a week to clean the house and water the plants?

Can't those fellows do things for themselves or do they have physical decline problems where they are unable to fend for themselves... and that is why the rehab facility felt it was better to keep your friend there until her ankle got better?

I am just trying to get a better picture of this situation.
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Call the patient's rights advocate, should be available to any patient in a facility. Unless the gov't did away with this job.
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Rehab is typically a voluntary activity. If goals are met, the individual services such as PT and OT and speech therapy would discontinue, and discharge would be planned, so on the face of it this doe not quite make sense. Just keeping someone for as long as funding is available is generally wrong too. A facility may feel an obligation not to discharge to an environment they know is unsafe. You can typically demand to discharge against medical advice, though then the costs of the stay may not be covered. The big question is whether that would really be best, versus fixing the concerns at the home which may be very valid...or may be a total smokescreen for a profiteering rehab center that is not worthy of the name and is trying to keep paying customers as long as possible. Maybe get an independent OT or PT home evaluation done...then involve the ombudsman or office of long-term care to find out what the discharge requirments and goals for a non-AMA discharge would be, or consider requesting transfer to a different facility on the grounds of not getting services.
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Here is my 2 cents. When I needed PT, I chose which place I wanted to go to. It's kind of like which pharmacy you will use. If my doctor would have told me which one I was to use, I would have told her to take a flying leap, I was going to use the one I wanted. It sounds like your friend is being held against her will. Even if it is a very small town, go see a lawyer about getting her out of there. The lawyer is bound by confidentiality however small the town is.
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