My 75 year old mother has many medical issues, most recently she was in the hospital for flare up of diverticulitis, during the stay she got CDiff. They released her after 10 days but she had fluid overload. I had to move into her tiny apartment to care for her, she couldn't get in/out of bed or to bathroom without assistance, never mind basic hygiene or food. After 5 days we finally got a VNA visit and nurse agreed with me that mom needed to be back in hospital. Ambulance was called but my mom refused to go. Luckily after 24 hours I convinced her she needed to go back to hospital. The treated her for the fluid overload, severe edema in legs, and Pulmonary edema. At the hospital she had a second occurrence of CDiff. After 14 days she was released and agreed to go to a rehabilitation facility. She was getting stronger and able to walk to and from bathroom with a walker but could not get into bed alone due to still having edema in legs/feet. Well yesterday she fell during PT, right to the floor when trying to sit into her wheelchair. So now she has gone backwards. I am trying to stay positive, rehab says typical stay is 7-14 days. I can't imagine her being ok by then. I can't move in with her, her apartment is so small, I work from home but have my own family and children. My husband is great but there is no quality of life for her or myself in this situation. Do I have rights to get her stay longer in rehab since she fell in their care?

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In reality, rehab is normally 20 days paid for by Medicare. It can be up to 100 days, also paid for by Medicare, if your mother is making progress and if the PT/OTs deem it's necessary for her to be there for that length of time. IDK that you have 'extra rights' b/c she fell 'in their care' b/c accidents happen all the time with weak elders. If your mother hasn't rehabbed sufficiently to leave within that 20 day period, then you need to speak to her case manager about extending her stay longer, and also make sure with her secondary insurance carrier that they WILL pay for day 21-100 (or however long they'll cover). Get all your ducks lined up so you'll know what's going on beforehand.

If your mother doesn't rehab well enough to be released back to independent living, they will say that she needs long term care placement permanently, or, to have 24/7 caregivers at home. Which is NOT going to be you, so then you'll have to deal with that situation if it should arise. You'd have to apply for Medicaid most likely, to keep her in long term nursing care on a permanent basis.

Best of luck.

Thank you for that advice.

Just to add to lealonnie’s comment about “then you'll have to deal with that situation if it should arise”. It sounds as though things aren’t going well so far, so the future problems are quite possible. It takes most people quite a while to check out the options, complete application forms, wait for answers, wait for places etc. Approvals for placement don’t normally have to be accepted immediately (you just lose your place in the queue), so it might be worth starting early. It’s a trial now when you are focused on mother, but it’s even more difficult if she is in a crisis situation. Best wishes, Margaret

My question is, why did she fall to the floor. Of all people a PT should know how to get someone back into a wheelchair. If Moms a big woman than there are PT assistants that can help, 2 person assist.

I was told for every day a person is in a hospital and released to get their strength back, its 3 days of PT for every one day in the hospital. Your Mom was in 14 days x 3= 42 days of rehab. With your Moms problems, 7 to 14 would not be enough.

As said, Medicare pays 100% the first 20 days. 21 to 100 is only 50%. Moms is responsible for the other 50% either private paying or her supplimental pays partially or fully. All this information should be given to you when she was admitted. Someone had to sign payment responsibility paperwork. That paperwork shows what the 50% cost will be a day. It will also show if the supplimental pays all or nothing against it. This way there are no surprises when you get the bill for the days Mom was in for. As long as she needs the therapy and she is progressing, she could be there passed the 20 days. If she plateaus, meaning there will be no further progress, then she will be discharged. At this point you ask for a 24/7 evaluation. If its felt she needs 24/7 care, then tell them it would be an "unsafe" discharge because she lives alone and you cannot provide the care. Hopefully there is LTC in the same building/complex and you can have her transitioned over.

Only if she continues to make progress will they extend her stay and will Medicare pay for it. That she fell may already penalize the facility in terms of reimbursement, so they may just want to cut their losses. And I am sorry to say that! It's just that I've seen too much of our s#itty healthcare system put profits over people.

How realistic is it for her to return home - to her tiny apartment - even after rehab? She has severe chronic illnesses and poor quality of life. Might a nursing home or assisted living be a reasonable thing to look into at this point? Some of them have wait lists. The good ones usually do.

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