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To make a very long story shorter, my mom had a bad fall at home three weeks back and is now in a rehab facility in New Jersey. This facility also offers extended care at the same location. My family (dad and sisters) have been increasingly pressured by the administrator, staff and social workers to take pre-emptive measures to move Mom to extended care with no real PT ever since the first looming Medicare coverage deadline. We already received a 6-day extension, and we are aggresively seeking coverage for more days. My mom has a long diaganosis including a broken femur. Today, we saw her orthodedist who recommended particular "programs of therapy", and he removed her leg brace so she could expand excersises (non-weight bearing at thus time). Her arm cast was removed so she may begin rotator cuff therapy (clavical was broken). She also got the go ahead for the toliet and shower (with seat). When we arrived back to the rehab from the doctor's office, we hurrily gathered in Mom's room by her therapist. "Whis doesnt change anything" he said, "it's all restorative therapy" he said pointing at the doctor's report. So I called the doctor's office to confirm. Bottom line is, the staff at this center is unwilling to work with my mom and us, and are essentially threarening to create a negative (status quo) report to the insurance company, and essentially misrepresent the orthopedist's report. We are all now under great stress with the next end of coverage day being next Thursday, 5/4. The next report will be submitted on Monday, 5/1. All words of wisdom are welcome. BTW: after some post-trauma dellirium, Mom is very coherent. There are many vacancies at this sub-acute facility. Mom is 87.

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Another thing; ask them if they are abiding by the revision of CMS regs that occurred as he result of Jimmo V Sibelius. Restorative therapy CAN be covered and if they say it can never be covered, then they don't know what they're talking about.

Make sure you are talking to the Director of Rehab services and not an individual therapist.
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Every decision from any type of facility is about money; when the patient can't progress in therapy in a pre-set deadline established by the insurance company - for whatever reason - the insurance company will fast forward the clock on the cut-off date for no more payment to the facility; because this facility is charging A LOT of money to the insurance company; in-home physical therapy is ridiculously cheaper for the insurance company. In a facility and in the patient's home the insurance will pay up to three times a week for PT. The actual cost of PT service in a facility versus in a patient's home - is nearly the same;there's a minimal price difference for the exact cost of restorative therapy; look at bills and compare. I've done this before so I know how it all works. In our area palliative care off in-home therapy of PT, OT, Speech. Get on the phone now to see if this an option. The other option is bringing her home and working with her primary doctor to get an order for these in-home therapies from home health. Your loved one may actually do better with therapy in her own home because she is comfortable and this will be better for her mentally. Don't transfer her to the nursing home. She'll just deteriorate even further and she won't get the rehab care she needs. You should also think of her quality of life; rehab for 80-plus year old is much, much longer than for a 25-year old. My advice is find a way to continue therapy in her home.
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I wish I had some words of advice for you. Unfortunately, my experiences with rehabs have not been positive ones.

My father spent five weeks in rehab after he became ill from a prostate issue that also came with a UTI. My mother spent three weeks in rehab after a fall. In my fathers case - he had walked in fully under his own steam but left having to use a walker. My mom went in with mild to moderate dementia and went home with moderate dementia that quickly became much more pronounced.

Okay - maybe with my mom it was the fall that accelerated the disease but what happened to my dad was inexplicable.

I did sit in on a few of my dads occupational and physical therapy session- which only infuriated me as they spoke to my very accomplished father - with absolutely no dementia- as if he was a child. Their main concern seemed to be that he learned to set the breaks on the brand spanking new walker they got for him.

Anyhoo- if I were in your place, knowing what I know now - I would say you've got two choices. Either move mom to SN or get her the heck a out of there - either to a better rehab that will commit to her receiving physical therapy, or take her home and arrange to have her receive PT/OT there. Good luck to you - its surly a frustrating time.
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Is there another rehab facility she could be moved to?
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Get mom's orthopedics doctor on the phone today and and her/his advice.
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Yes, some (many) rehab facilities are just worse than worthless. There is a brand new one here (a couple years old) that my Mom was at. They did nothing for her! They even yelled at her when she used her wheelchair to walk...since they never gave her any physical therapy. They had a beautiful gym, great looking facility....no service at all.

They also had a long term SN attached. I believe their plan was to render their rehab patience into invalids then transfer to long term.

They pulled on Mom the same crap this place is going to pull on you.....

I have spoken to many people in this area....everyone had the same experience with them. How they can keep operating like this?

I ended up getting Mom, and bringing her home. We did physical therapy at home...and she got back on her feet...no thanks to that place!

Medicare authorized PT 3 days a week, and OT 1 day a week.    This lasted 2 months.  
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Gee
Twice mom has been in rehab following falls and each time they got her extended a bit beyond the 21days

I would think restorative therapy is a good thing - do you know what they're looking for as it sounds like she's making progress ?

Do you have plans in place for mom to return home ? While you can get a therapist to make home visits 2x a week it may not be enough yet

Does mom have supplemental insurance to cover the cost after 21 days? If so, I'd give them a call
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Dear Alex,

Its very unprofessional of them to put any pressure on the family. You must do what you feel is right for your mom. I hate to threaten lawyers on them, but sometimes I feel this tactic might make them back off. If not, I would try to escalate my concerns with a manager at the facility.
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