My partner is in an inpatient rehab from hospital discharge. He is making progress however slow. He can't come home in a wheelchair because I can't physically help him. Inpatient facility wants to discharge him. He's been there 1 1/2 weeks. What can we do?
Because YOUR evaluation and the patient's evaluation may not match the expert evaluation of the rehab.
There are many reasons for discharge and this is something, if you are next of kin or POA you should be included in by law-- legally mandated discharge conferences. There, the personnel, whether nursing or PT or OT will tell you of progress, or lack of it.
Some patients cannot fully participate. In those instances rehab is a waste and cannot be legally covered by medicare funds.
Some patients have made all the progress they can make in rehab in the opinion of the experts.
Briefly, the answer is yes, discharge can happen before you or the patient are ready if the facility believes that the goal is met, or if they believe it CANNOT BE MET.
Now we come to the important part for you:
If this patient is not well enough now to return to your care then THAT is what you need now to make clear to discharge planning, social workers at rehab. In facility placement may be necessary.
DO NOT ACCEPT home someone you cannot physically/mentally care for. THAT would constitute an unsafe discharge.
The rehab will tell you all sort of lies. "We can get equipment" , "we can get you help", "we can make this work". They won't, they can't, and it won't work. So don't buy that and tell them this old RN told you so.
Best of luck to you.
About a week of rehab he fell in the bathroom because he couldn't get anybody to answer his call light he tried to go on his own. He hit his head and has a huge knot and black eyes. He was transported to the hospital for exam.
A week later our insurance decided he was able to be discharge. Although he was in worse shape than when he went in.
I couldn't possibly bring him home and was given 48hrs to get him out!
I ended up admitting him to long term nursing care at the same facility. Self pay!
This is emotionally, financially, and dealing with all the bills and running back and forth to the NH is taking a toll on me.
although I'm relieved from taking care of him at home 24/7 I can't help feel guilty too. He keeps asking to come home.
Have you had a care meeting with the social worker and other staff at the rehab? If not, request one and ask for the physical and occupational therapist to be present.
The other option would be to consider getting his doctor to order home health where he can continue PT and OT at home.
If you want to avoid skilled nursing for now, would it be possible to hire additional help at home?
Wishing you and your partner all the best.
I would appeal.
You mention that your DH is currently in a wheelchair. He is taking 50 steps with a walker and on oxygen. I'm assuming that he didn't leave home with ANY of these things correct? Oxygen, walker, wheelchair? They will be able to help him get to a certain point, but there will likely be limitations even with hard work on his part. And they may already be able to see that in his daily PT and OT.
That being said - as you said - it is an unsafe discharge for him to go home right now - so Skilled Nursing is the only option.
Beds are a revolving commodity. What is available right this minute - won't be there in 24 hours or even 12. They are asking for additional options because there is no availability where you prefer him to go. You could look into it on your own - entirely private pay and private transfer and might potentially have more luck. But it's doubtful.
You could appeal it - but that takes time and in the interim they could try to force your hand - and the response to that is that he is an UNSAFE DISCHARGE. Learn those words. You cannot and will not take him home and he is an unsafe discharge.
Here is the thing we were told multiple times at multiple facilities. If FIL was "discharged" from the rehab - then he became skilled nursing care and he had to pay the private pay rate until he left as long as he occupied their room. Now I don't know if that is an option for you. But they weren't going to kick him out on the street because they knew they were playing with fire because he wasn't in a position to go home. There is some wiggle room typically - you just have to pay out the wazzoo for it.
We never actually had to use that - but the last facility did keep him until we were able to get him transferred to his SNF.
Repeat after me - UNSAFE DISCHARGE.
See All Answers