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My mom is currently in the Rehab facility in New Jersey after the surgery. She is somewhat weak, but not to the point where she can't stand up an use the wheelchair or some assistant to move around. I had a meeting today with the rehab nurse, the social worker and the doctor who said that she is not strong enough to go home. And, if I take her home, I will have to sign that I am taking her against the medical advice and the insurance Medicare would not pay for her medical services once she is at home. This is nightmare and i feel powerless that I can't do anything about it. The rehab is telling me she might need another two to 4 weeks to get stronger, but after that they might say she is still not well enough and can continue to hold her there against her and my will. Is there any law that I can use to force them to discharge my mother and assign her for a home medical care. Do you think i need an attorney to resolve this matter.


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Sugar, Medicare will not pay for at home custodial caregivers 24-7. Medicaid in many states has long home waiver lists that may not begin coverage immediately. Check before you make a decision thinking you will have coverage at home at no cost 24-7 only to find the reality is different and you are now the only caregiver.
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Right now i am taking my uncles to probate and family court, the law states that a person of sound mind may choose to leave a care facility or hospital to go to another care facility or home, even if it could result in the patients death. Medicare/ Medicaid will pay for at home care provided you mother has a primary care Dr. see her and put her under their care and state that your mother is not rated disabled enough for nursing home care. Or have them state that leaving her there will cause her mental and emotional health to decline.
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I would do some research on what Medicare will pay for while she is in the home. I had the same issue with a nursing home in Oklahoma. My mother told them she was leaving AMA and they cannot stop her. She still has the right to refuse treatment from any provider in AMERICA. For any reason. Medicare should pay for physical and occupational therapy in the home for as long as her doctor prescribes it. Please keep us updated on the outcome of her journey. Prayers go out for you because there is a lot of things to do in order to take care of the needs of an adult with health issues. A lot of things can be done for her by family members therapy wise. Simple chores.. ie.. washing dishes, folding clothes, brushing her teeth, simple things just like she taught you to do as a child. Good luck on your journey and please don't let anyone tell you she can't leave where she is because they don't have the right to stop her.
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What do the doctors say her level of care needs to be?
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My Grandmother is in a nursing home her Medicare is running out Thursday. I have a meeting today. She's been begging to come home can i discharge her even if the social worker and doctors disagree.
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The facility may have found that she has plateaued/reached the level of functioning that she had before hospitalization OR she is not going to improve any more and care has become "custodial" not medical rehab. You need to file an appeal.
I found this info on the Medicare website,
What if I think my skilled nursing facility (SNF)
coverage is ending too soon?
When Medicare coverage of your SNF stay is ending because it’s no longer medically reasonable and necessary or is considered custodial care, you’ll get a written notice (“Notice of Medicare Non‑Coverage”—
NOMNC). If you’re getting Medicare‑covered services from a SNF, and you think your Medicare‑covered
SNF services are ending too soon, you can ask for a fast appeal. Your provider will give you a NOMNC before your services end that will tell you how to ask for a fast appeal. (The notice might call it an “immediate” appeal.) If you don’t get this notice, ask your provider for it. With a fast appeal, an independent reviewer called a Beneficiary and
Family Centered Care Quality Improvement Organization (BFCC‑QIO) will decide if your services need to continue. ■It’s important to call your BFCC ‑QIO to request a fast appeal no later than the time shown on the notice you get from your provider. Use the phone number for your BFCC‑QIO listed on your notice to request your appeal. ■Ask your doctor or other health care provider to submit any information to the BFCC‑QIO that may help your case. ■If you miss the deadline, you may still have appeal rights:
If you have Original Medicare, call your BFCC‑QIO.
■If you’re in a Medicare health plan, call your plan.
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My mother was diagnosed with brain cancer, Glioblastoma Multforme and received radiation and Kemo treatment. After her treatment she was sent to a Rehab nursing facility for rehabilitation for OT, PT and speech therapy. She was admitted on March 18 and they want to discharge her on 4/6/2017. The family is appealing their decision as they have to understand that it takes time for a 75 year old woman with such condition and treatment to become fully strong for therapy. She lives alone and should not be permitted to leave Kentwood without a safe discharge plan, I also thought Medicare pays 100% for twenty days and 80% for 100 days. Why was my mother not offered this. Please advise.
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akgirl1961

Pamstegma is right, Rehab will charge her room and board the longer she stays.That is out of your pocket, It's all about the money.
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akgirl1961, once the rehab is done, the patient is released. Any stay beyond that is full freight out of your own pocket.
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My mom had knee replacement surgery. She is 78 and lives alone. The Rehab facility she is in, wants to release her 2 days before my husband can get down to AZ to take care of her. Can they legally do this. She will be 2 weeks post surgery when they release her, but she will not be able to drive yet.
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my mother has been in a rehab center for a couple months now and is not happy with where she is and would like to come home is it possible that she could sign herself out of rehab and go home
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Short answer - generaly it is a myth that AMA discharge results in bills to the family; generally planning to keep someone in order to maximize using all their benefits is wrong and should not be done; generally it should NEVER be AMA unless the person is really unsafe.

Long answer - As a rehab doc, I have done exactly two AMAs in my entire career. I had witnessed the scandal of a TBI facility practicing what was not-so-lovingly termed "fundsucking" by a disability rights activist I was honored to work with. That bascially meant they were keeping people until funds ran out, being dishonest with caregivers and claiming people were a danger to themselves or others, but then set them up for immediate d/c regardless of needs I was able to assist in a small way in putting an end to it, and after that I made it a point to write into our policies that rehab was elective and AMA was used only under extreme and unusual cricumstances.

In the eldercare arena, I have seen more people just want to quit rehab and go home who are not thinking real clearly about safety or maximizing their function, and it is important to be objective about that. I like the idea of using a third party like an ombudsman to negotiate and help decide, if speaking with d/c planners and maybe getting a team-family meeting to address specific discharge goals and what the person really needs to be able to do to return home safely. These are not cookie-cutter decisions but should fit the individual and their needs and desires first and foremost.
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That is a common answer for Rehabs some are dreadful to say when a patient leaves.
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The lady saying Medicare wont pay isnt exactly right.Thats a standard answer medicare and HMO's will pay if they leave early.It's a bill that's all it is to medicare and others.
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Thanks Family. Your comments are very helpful...when the Medicare funds expire after 20 days,on the 21st,she got to return home...All the officials at this Physical Therapy Center...know this...at the other center too...I've been taking care of her for 30 years! And I will continue,"until death do us part."

Her leg is still swollen and hard! Should I sue?...one of them told me this morning:"She said to tell you,to bring her check." Why would I authorize such unaffordable and unnecessary expense!?

Medicare will continue paying for a Homecare,Physical Therapist;already have! This is what insurance is for. Right? DAH! That's $162.00 daily=$1,134 a week! One month would cost us,only $4,536!

Thanks for being here for us.

They must think my middle name is Trump! Kapish!? I mean,comprende!?

Humblebrother,
Marietta,GA.
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It's medicare abuse plus elderly abuse
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My ex wife is in one in Birmingham now.Her sister is a drug dealing addict and is going thru her house helping herself to items driving her car.The rehab told her they knew a realtor that could help sell the house to get her in a nursing home.I told her everything (THE ADMINISTRATOR) of the rehab she just blew me off.They keep her doped up to she has tremors.I ask 3 times for a nurse to take her to the bathroom.They babysit with drugs.In the meantime they are racking up with medicare money.I reported the things to DHR and they said to get her out if her sister dont have a POA.It's a terrible place but clean appearance if that makes sense.Once she's out of there I will report it to anyone that will listen.But of course I cant tell yall it's Arlington Rehab in Birmingham Al
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My father-in-law arrived at rehab on a Thursday after a fall due to an uti. He was hospitalized from Monday thru Thursday and released to a Assisted Living/Rehab Facility in NJ to regain his strength. According to the Rehab facility his uti has since cleared up. However, he is still disoriented and much weaker than when he went into the rehab facility. As I mentioned he arrived on Thursday and fell at the rehab facility on Saturday and again on Monday. The rehab facility new of his agitation, confusion and continued effort to get up from his wheel chair. Prior to all the above he walked freely on his own and occasionally used a walker. I feel that the facility is not taking proper care or precautions to ensure his safety. I wish to have him transferred to another facility. Would I need to contact the social worker, insurance company or can I just remove him and have full time care provided in home?

I feel for everyone is this forum and I hope that thing need to change with the care of our elderly. If a facility is to charge a patient $300/day, the care should be phenomenal.

Thank you
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Too many emotional personal opinion advice type answers. The answer is simply NO. NO they can't force anyone to stay against their will. If the patient/mother is not able to make that decision and you have POA, then you can even sign them out or even outright take them. You can even leave a hospital if you wanted. Not that it would be wise to do so, but strictly speaking legally you can't violate someones civil rights and holding someone against their will or the will of family is basically kidnapping. Sometimes these places have gung-ho nurses/social workers that get too attached and inject their own opinion also which just further muddies the water.
This is basically a money thing. The facility/rehab is operating under CYA (cover your A$$). The benefit financially from having patients stay there longer, the staff and the doctor does too. When money is involved you have to watch out, because all kinds of b.s. crops up. All too common in the medical field these days. It's one big money making sham.
The easy way to go after them is to hit them in the pocket book. Explain the longer they keep them, the less likely they will get their co-pay or money (if it's say past the 21 days of medicare and no supplimental medicare). Sometimes economics speaks louder than anything.
One time this happened to my mother. she had the full 100 days or so of medicare, and the facility had no choice but to discharge (again money--they get most of their dough from medicare or the insurance). Then they illegally threatened that they wouldn't let her go if they didn't get like at least half of their money owed at time of discharge. ILLEGAL.
Patient and family has a right to do what they want, period. If that's what your parent /family want and they are still giving you grief, call the police and report an attempted kidnapping. This is a civil issue and nobody has the right to hold someone against their will no matter what they sign or don't sign.
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my brother who is 59 his told me he broke his bed but when i came there the bed was good also she tells him he belongs in belvue all the time and he is quite capable just coming home from hospital from a wound and i also found out that this woman has been taking time off what schould i do
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Contact your long term care ombudsman who can assist in advocating for your mom.
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I went through the same thing with my brother. They kept dropping sugars to dangerous levels, he is now at home with me. I will never allow another family member to go in a rehab. I will take care of them myself. Them places do not love a person, it is only a job to them. He is home and doing well thank god for that.
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Here is a link to an ombudsmen for the elderly. They are the people to talk to and help you.
http://www.aoa.acl.gov/AoA_Programs/Elder_Rights/Ombudsman/index.aspx
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LOVEFORMOM, if you remove a patient against the advice of the rehab facility, you need to be careful, your Mom's insurance might not cover any continuing care after that date.
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dont yell at the social worker. its counterproductive ..
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You need to have a conversation with the social worker to find out what is going on with your patient.
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CAN REHAB KEEP MY MOM IF IT IS NOT DOING HER ANY GOOD AND ME BEING HER DAUGTHER CAN I GET HER OUT TO TAKE CARE OF HER MYSELF
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my daughter is 39 and in a skilled nursing facitlity,she says they are not giving her meds.for some reason,they never said they was stopping the meds.but she says she fills great since they stooped the meds,and wants to now come home can she leave without doctors permission?and since we have signed her up for medacaid will this effect that in she just leaves
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I would ask her personal doctor to access if she is able to come home. The amount of services you will be able to get from medicare while she is home is very limited. So I would be sure I had enough money for a full time and or live in home health aide. Living in NJ I know these costs are high, normally it will run about $2,000-$2,500 a month at least. So if she qualifies for rehab and is showing some progress, it may be worth letting her stay a month or two in rehab. However, most rehabs in NJ are not wanting to keep them past the first 30 days, they will be eager to sent her home. I would focus on what medical supplies you will need in the home and get it ready for her to come home.
Generally, you will need to spend time and money on various medical equipment if you have not needed these things up to this point.

If she is still weak you need to guard against her falling in the home. If she wants to come home and is pushing for an early release from rehab, try to reassure her she will be home but needs to get a bit stronger.

I had to move my father from a hospital stay to a rehab, and the rehab was not
that effective and wanted him out in under 30 days, I had to transfer him to another rehab for 30 days. Then the second rehab abruptly called and said I needed to take him home or to a nursing home in the next 3 days. I managed to get the home set up for him and a full time home health aide started the following Monday, I returned to work on Tuesday. I got the medicare PT, OT and an RN who checked on him. I was the home health aide outside of my work hours. My father did ok but he needed a home health aide or me with him the rest of his life --approx. 3.5 yrs.

I know the rehabs are not perfect. Been there. But try to think with your head and heart. Ask yourself, is she really ready to come home? Can she be managed with outside paid help and the family? Will she be a bit better in a few weeks to come home? What does her personal doctor think about her coming home early? If you feel she can be managed at home, I would take her home.
Despite what the lawyer said, I would try not to get on the wrong side of medicare. He may well be right on the law, but if you need to start a legal battle to reinstate her benefits (along with the heavy load of caring for an elder), it is a
battle you will not have the time let alone the money for.

Try to take care of your own health. As mom's caregiver, you need to pace yourself which is next to impossible. Good luck with mom and the rehab.
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sometimes your loved one feels stronger and better than they actually are and mentally long for their own house/bed etc but physically still need more time with PT, OT and healing. Thats what happened with my mother. She was transferred to a rehab center after an acute illness with hospitalization and was in rehab for the full 20 days that was covered by Medicare. It really was the best place for her to be even though it wrecked havoc with all our schedules by trying to visit her every day at the rehab center. Once she got home she was really far stronger than she would have been had she had her way.
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