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Patient and family insist on going back home, but social worker does not agree. How do I fight this?

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A rehab is not a prison. The patient who is mentally capable is able to leave whenever he or she likes. If, however, the patient is not mentally capable, then discharge has to go through the POA or guardian of the patients. It is the DOCTOR, who will not agree, not a Social Worker. The social worker is there to explain to family the reason the doctors feel the patient should not leave rehab care. The patient or the POA can override the "wishes" and "advice" of the medical community and take the patient home "AMA" which means "against medical advice". The patient's chart will reflect the fact that it was the considered professional opinion of the doctor that the patient was in need of more rehab and should not go home, that this was THOROUGHLY explained to all family and to patient, and that the patient left the facility "Against Medical Advice". This will leave a patient with a "non-compliant" with medical advice history that will follow them to other facilities and hospitals. It has no real repercussions but does indicate that the patient may have some tendency to follow the advice of expert personnel. As to the AMA papers that they will ask you to sign, they may tell you that you "have to sign the AMA form". This is not true. You don't have to sign anything. Again. This is not a jail. You are not held there against your will. You are free to leave if you are mentally capable or have a legally mentally capable person designated to take care of you on discharge.
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If the patient is competent, he/she is free to leave at will.
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Does the person receive Medicare? How long have they been in rehab?

Medicare only pays 100% the first 20 days. 21 to 100, 50%. The other 50% is paid by the patient or fully/partially by the supplimental.

Why is the person in rehab? To get their strength back? If so that can be done at home with "home care" coming in. For everyday they were in the hospital, its 3 days of therapy when in to get ur strength back. As said, you can asked to be discharged. It can be done Against Medical Advice but it will be the doctor who signs off. The Therapist can put her 2 cents in but a SW has no say in the matter. Don't let them tell you that the bills will not be paid by Medicare and the supplimental. This is a tactic to get you to stay and not true. Insurances will pay up until discharge no matter the reason for leaving.

The last time my Mom was in was for getting her strength back. She was living in an AL so I was watching every penny. I told them they better do what they needed to do in 20days because there was no money for additional days. She was discharged in 18 and I should have taken her out before then.

What you may have to do is show that the discharge will be a safe one. They are under the law not to release if its felt its an unsafe discharge. It maybe that the person needs 24/7 care so someone needs to be there. That its safe to get them in and out of the home. That its safe to get in and out of the tub with even temporary bars in place. That a shower chair has been provided, etc, etc. Now these things are probably the SWs job.
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