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She was in rehab for 14 days, but started to have skin breakdown, so now the insurance is trying to have her sent to a nursing home (at her expense, since insurance pays for rehab, but not skilled nursing home) the insurance covers 100 days of rehab, but 0 days nursing home. my sister is 64, she is making very slow progress. but the psych medications sedate her.

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Did a discharge planner tell you it would not be covered at at Skilled facility? If she is at an Acute Rehabilitation facility and not able to do 3 hours of rehabilitation a day they move them to a skilled facility that has a rehabilitation room and give them OT PT and speech if needed at the skilled facility. Insurance will usually cover skilled care minus the time in Acute Rehabilitation for 100 days if her progress is slower. If they told you that she is going to skilled and not covering it then you and your sister need to understand why. it could be she is choosing to participate or she needs more time to heal to be able to participate. Sit down with the discharge planner and hear what they say. there are times to fight and there are times to go along. Be authentic and share how you feel in a healthy way. I alway find that showing my vulnerability and asking someone for their professional expertise as if it was their family member gets them into their heart and they will do what the can do within the systems that they operate to help you.
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I've had my sister home with me when she can't walk. She has seizures and brain damage. Instead of having her go to rehab after a hospital stay that weakened her, I requested having her come home with me and having therapy come to my house. This was cheaper and my sister recovered faster in her own environment. It is a lot of work. I bought a baby camera for $70.00 at Meijer that lets me see her and talk to her when I am in another room (from my phone) so I can still get things done around the house. If she is on depakote for seizures, make sure she is seeing an epileptoligist neurologist rather than a regular neurologist. They can better control meds and therefore seizure activity. We found Vimpat more effective with depakote. Also, request a script for barrier cream if her skin is breaking down. If this is too much for you, you can always take her to the nursing home as a last resort. She is very fortunate to have a caring sister like you. God bless you both. I am praying for you and sending you big hugs!
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I knew someone in that position. Clearly this is iatrogenic, right? The Depakote harmed her as did the previous facility's negligence allowing her muscles to atrophy. It is gross malpractice in my opinion. They are well aware that if a person doesn't use their muscles they can lose a lot of muscle tone. They should not have left her sitting or lying in the same position, and it's their responsibility to get her up and walking so the atrophy doesn't happen. The side effects of Depakote are also known and documented. The fact that they are sending her to a nursing home is only cover-up for the damages they caused. The cover-up is very common since no one wants to admit fault. Their aim is to prevent a lawsuit. I'd get a lawyer if I were you.

When I didn't have the money for a lawyer and was in the process of trying to find one, I faked it that I had one (or was waiting for a callback) and actually that scared the heck out of the offending party and they backed down.

I had good results calling the attorney general recently. You will get action. Don't settle for their claims that they are doing an in-house investigation. A real investigation is external.
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Skin breakdown, as in pressure sores? That would imply that she is not making any effort to even reposition. If she is on a hoyer lift, she is definitely nursing home ready. So sorry.
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Never tried this...if she is ill, made worse by the care she did or did not receive, perhaps a visit to the acute care hospital (E.R.?) to be re-evaluated and her condition documented by a second opinion might help the insurance company see the error of their ways. E.R. is a covered expense, especially test for infection from the pressure sores. If it were my sister, I would fight for her like you are.
So, calling an ambulance?
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trying2do... Are you kidding? I've known healthcare workers who lied in court, including doctors. I've seen healthcare workers lie to their supervisors. I saw one steal from a patient and then, when the patient (to her surprise) reported the worker, the patient was assumed to be mentally incompetent and the worker got away with it. The patient had no recourse. While of course the lies and excuses of these workers appear dubious, a judge may believe the medical facility anyway, and not all judges are honest. Many can be bribed. This has nothing to do with emotions but people who are at fault being dishonest about the facts. Judges are working for the state and guess whose interests they protect? We wish they would protect the people but usually they protect the institutions.

If you know anyone who was harmed by malpractice, ask if they got their records. Go look at the records in malpractice and you'll see all kinds of inaccuracies, fudging, missing information that was simply pulled to protect the institution, and other very deliberate errors. Look at ProPublica's study on malpractice. The statistics are shocking to many.

Go watch the movie "Gaslight" and you'll see how workers treat patients in many settings. The United Nations has been alarmed at how elderly people with dementia are treated worldwide, and the USA and Canada are no exception.

While it's the law to act a certain way, there's no guarantee that the laws will be respected and followed. It's against the law to litter, against the law in some communities to not pick up after your dog, it's against the law even to jaywalk in some places. And in every way, "Do no harm" is both ethically and legally binding. Tell me that one is followed!
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I thought Medicare paid for a certain amount of days in a nursing facility. I just read there are certain circumstances. If ur sister doesn't have money, Medicaid should pay. The social worker at rehab should have explained this to you. I agree, that maybe things should be checked out concerning the rehabs part in all this and the hospital.
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"Blame the patient" is the norm in malpractice cases. Expect them to go to extremes to avoid admitting fault. What I have seen is re-diagnosis to something else, with the claim that it was "underlying" and have that explain away all your sister's injuries as if her new "illness" caused it, never them, never. The doctor is always right and they act like gods on high.
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Yes, she should be in an NH.
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Have you talked to the Social Worker at the rehab. Explain that ur sister is not able to afford her care. They may be able to help with Medicaid.
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