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Hello, new to the forum and need input. My mom is currently in a
Skilled nursing facility for physical therapy.
She was hospitalized 8 days for severe hyponatremia 3/15-3/22, then sent to rehab. On 3/26 during a therapy session, she got shaky, was sent back to the hospital. Spent another 7 days recovering from a UTI and 'hospital induced delirium'. Do nursing facilities have to inform family members of her plan of care or share progress reports? My sister & I have never voluntarily been informed about anything regarding mom's care. I visit daily, call her several times a day. Made several attempts to get information, but no luck. Her nurse verbally told me what meds she's taking & lab results, only after I asked 3 times. Any thoughts or advice would be greatly appreciated. Thank you

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Something else just occured to me. Unless your mom has been declared incompetent or is in some way "out of it", it seems likely that the facility feels that they've discharged their "duty" to inform by getting your mom's approval for her care plan and keeping her abreast on her meds and such.

Are you your mom's health proxy and/or has she signed a HIPAA form allowing you to be privy to her health care information?

In several instances, my mom was informed of medical information while in rehab; she would forget to tell us or misunderstand what they were telling her.

This caused lots of anguish and misunderstanding between us and staff.
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Do you have medical power of attorney?

You mother has to give permission by signing forms saying that her medical information can be discussed with you.

I also had a stack of papers to review and sign when mom entered the NH for rehab.

Later, there will be meetings with the social worker and staff (PT and OT) to discuss progress.

Your situation is different due to your mom returning to the hospital.

Ask your mom if she filled out the necessary paperwork.

Best wishes to you and your family. I hope your mom starts to improve soon.
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If you don't have POA then NO they do not have to tell you. However developing a good relationship with those who are caring for her will get you more information than worrying about the legal poisition.
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Generally, staff can not just tell somebody about a person's condition without that person's consent. It is part of HIPPA laws that protect a person's privacy. Contact administration. They should have somebody listed as a contact person for information. Also arrange so that one of you is contacted regarding changes in her condition.
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Under the Affordable Care Act, and IF you are an authorized contact person, you have a RIGHT to know what is going on with your loved one. If anything you SHOULD be able to access her medical records with patient portals. That is federal law. But you MUST be the legal designated contact person. It's really quite simple.

https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/access/index.html
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You call the social worker and them to schedule a care plan meeting.

In most facilities, the Director of Nursing (DON) is the queen bee of the facility. S/he and the facility Social Worker are the folks you get AND GIVE information to and from.

Talking to regular staff (the folks who do the front line care) is important but won't get you the official information.

A good care plan meeting will have the DON, SW, Unit Manager and therapists in attendence, some by phone. Come with a list of questions.

If you are interested in transitioning mom to long term care, now is the time to bring that up at the meeting.
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Your mom needs to assign you as her Medical Representative on the HIPAA form, and she should also, when recovered, assign someone as her medical and financial PoA. Without these legal protections for her, if she slides into cognitive decline it will be legally possible to manage her affairs. Go to an elder law attorney for this, and be sure to also discuss Medicaid qualification (in the future, if she ever needs it) be because the cost of care is such that many many responsible people who saved for their future wind up needing it and there is much to know to avoid being disqualified, as there is an application financial "look back" period of up to 5 years but no less than 2-1/2 years in each state. Have her also create a Living Will with the input of her physician and be sure to keep a copy and submit another copy to each doctor clinic she works with.
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If you are not listed in mom's medical records as being able to get information the fact that they even told you about meds and lab results is illegal.
HIPAA laws are very strict.
Make sure you are on each and every form as someone that they can give info to.
She should have a POA for medical and financial decisions if/when she can not make decisions for herself.
And without POA if it gets to the point where she can not make decisions for herself you or another family member might have to obtain Guardianship in order to make the necessary decisions. (unless she has a husband then he legally can make decisions for her both financial and health)
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You need to be listed as someone they can talk to on their records regarding mom's care. I have DPOA with medical and financial authority. I make sure my name, my husband's and my brother are listed as someone who can be provided with the information.

However, since Mom is competent, the facility doesn't always call me regarding what is happening with her. There has been 4 or 5 Directors in the 3 years she's lived there. I had great relationship with 2 of them and they kept me informed, knowing mom would forget to call me. The newest one hasn't been broken in yet - and since she isn't a nurse like the last three there is now another layer added.

However before my father died - he'd been moved to the the SNF where there were meetings every 90 days re his care. I again was the one called as I was his agent as well. Again, my brother, husband, mom and I were listed on who was able to get information. I was the one they called when he fell - which was weekly. SNF at the community my parents live in (mom is in AL) was not all that great and dad wouldn't have stayed there but for mom being able to visit him anytime she wished. If mom ever needs SNF it will not be at this one. The point is, make sure everyone the family wishes to get information is listed on the appropriate paperwork.
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jacobsonbob Apr 2021
The newest one hasn't been broken in yet..." LOL, this is a great way of putting it! Hopedly, you'll be able to get her "trained" to obtain and convey the information you need, without too much bureaucratic hindrance.
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The POA only is informed, and yes, the POA should be included in nursing conference even if only by speaker phone. There is usually a weekly care conference, the first including all members of the team from nutrition on. Then that family member may share what information they feel relevant with the rest of the family, some sort of informative phone tree of relatives. As you can imagine, they cannot speak with more than one family member, that one being current POA or guardian. If there is no such person assigned speak to the Social Worker at the facility to see if she can get temporary guardianship for the family member chosen. I am assuming that your Mom is not perfectly competent, of course. If she IS, then it is up to her who is included in anything regarding medical information if she did not create someone POA.
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