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My father had a recent hospitalization/rehab center stay, and was discharged home with PT, OT and health aide services coming to the house. My mother has declined OT services when the staff came at an "inconvenient" time. They have not come back since. Can this be considered non-compliance on my family's part? Does refusing one session jeopardize the order?

A big mistake to refuse. This can be considered non-cooperation. Surely it is clear that a person or a team cannot come to the home and be sent away because it is convenient. And yes, it might not be covered by medicare/medicaid after that. I would call and explain it will not happen again, and try to get it back. If it does happen again I doubt sincerely that they will go for three strikes.
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Reply to AlvaDeer
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The problem I have with in home therapy is that they want to do it in their time. And you can understand this because my Mom was not the only client. PT where I live is usually in the morning, OT is afternoon. With me Mom was released into my care on a Thurs. She had Dementia so living with me was new for both of us. I literally got a call right after we walked in the door asking if they could come and admit Mom the next day like 8am. I told them no, I would rather wait till Monday to give Mom and me time to adjust. I had no idea her habits. They agreed. I also told them that 8am would be too early since I had to get Mom up, dressed and fed and 8am was just too early. So we agreed on 10am.

Were u there when Mom told them it was not a good time? I would call the office and first relay what Mom told you to see what the therapist or Nurse put in her notes. (The first visit is usually a Nurse doing the admission. Then u hear from the Therapist/s to set up times. Your parents should not have to change their routine to accommodate the therapist, it should be the other way around) Then ask when they will try again. I would think just like doing rehab in a facility, the patient has 3x to turn down therapy before they are discharged for noncompliance. Ask them to come at a time convenient to your parents. Then tell Mom the time of the appt because she needs to let them in. And because there are other clients, the Nurse cannot keep coming back till its convenient for Mom.
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Reply to JoAnn29
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After a few no-shows ( on the patient's part) the PT or OT will quit wasting their time. It's also a money waste, as after a couple of no-shows or late visits they cannot always bill for 'nothing'.

In home OT and PT have to rely on a pretty tight schedule to get to see all their patients in a timely manner. Mother would just be sitting down to eat and her PT guy would come and she'd offer him a chair so he could wait for her. He didn't put up with that, just said "Mrs T, I have an appointment with you at 2. Please be dressed for PT and ready to go at 2, because I have an appointment with another patient at 3."

They always scheduled around MOM'S convenience, so them showing up at 8 am wasn't happening. It was just mom being mom.
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Reply to Midkid58
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It would depend on the circumstances, for example on what exactly your mother said and whether or not it was reasonable for her to turn the staff member away and on what understanding she did so.

Say the OT had made an appointment with your parents' positive agreement; arrived on time at your parents' house; and was sent away with a flea in her ear and your mother's roundly expressed view that she, the OT, was a waste of space. (I am merely giving an example, you understand. I'm not suggesting that your mother would be so rude). That would certainly be non-compliance; and although a good service would see the funny side and do its best to persuade your mother to think again, you could understand that they wouldn't be happy to waste their staff's time.

But if the OT turned up unannounced, except for some vague mention at the rehab center that there would be a home visit at some point, and your parents were in the middle of lunch, and then there has been a misunderstanding about who was to telephone whom to rearrange the visit, that would certainly not be non-compliance.

Either way, surely the thing to do is to contact the community-based team's office and just rebook? How many times has your mother declined service, and do you agree that she was justified in seeing the visit(s) as inconvenient? And don't forget that whatever your mother may have said, your *father* is the patient. If he hasn't turned them away himself they haven't a leg to stand on when it comes to trying to discharge him.
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Reply to Countrymouse
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My husband sometimes refused PT services. Of course, it doesn’t look good on the record for Medicare, and it’s difficult on the therapist who took time to drive there. But, they should reschedule and try at least once again.

We usually knew when they were coming, and they just waited if I was in the middle of dressing him or something when they arrived. If he refused to participate, they at least took his blood pressure and pulse, etc, so they could write it up as a visit. Medicare is very particular about these things.
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Reply to JuliaRose
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