Follow
Share

A friend had an amputation and insurance denied him a rehab facility and placed him in a nursing home where he is not getting the appropriate care. He has United Healthcare. We know nothing about any of this please help.

Find Care & Housing
Generally, when, after hospitalization-surgery, rehab is REQUIRED for a patient, it is covered by Medicare, not insurance.
If further rehab-care (after government-assisted time is used up) is required then it may become and insurance issue.

It is honestly impossible for a "friend" to function for another "friend" in the healthcare system of Hospitalization, Rehabilitation, Extended Care Facility Care. Friends don't have the knowledge, the power, the expertise to do this work.

When someone needs help functioning in this system it is firstly up to that person; if that person is unable to function for him/herself then it must be a family member who is CAPABLE of functioning as a MPOA (medical power of attorney) and who is duly appointed, and documentation done. That person honestly needs a certain amount of expertise in that very sophisticated and complex system. Otherwise a manager such as a medical nurse-manager needs to be hired to help.

Your friend has, for whatever reason (no one really can guess) been declined rehab care. He/she is now in extended care placement. He/she will have to now contact the facility or his medical care practitioners for a social worker or case manager to help work through what is or is not available.

I'm sorry. Each person is a fraught and unknowing as any other in this system. No strangers really can be of benefit to you, or to your friend, whose case is as individual has his/her own fingerprint and as complex. I wish you good luck.
Helpful Answer (0)
Reply to AlvaDeer
Report

How old is your friend?

Does she have a medical Power of Attorney who can legally advocate for her? If so, this person needs to be called in to begin to act on her behalf.

If your friend is someone who was needing assistance prior to this surgery, then she may not be getting appropriate attention wherever she goes, since rehab is not like Assisted Living -- you can help her by making sure she is eating and drinking enough daily, and that her hygiene is kept up.

An elder is often at-risk post-op from UTIs and hospital delirium. Someone needs to be her Medical Representative at the very least (she can ask for and sign the HIPAA form naming someone, like yourself).
Helpful Answer (0)
Reply to Geaton777
Report

Health insurance does not provide long term care in a Skilled Nursing facility. They do, however, provide rehab for up to 20 days in a Skilled Nursing facility. Your friend is likely in this nursing home FOR rehab purposes and not permanently for long term care. If so, someone has to find her another approved rehab SNF to transfer to. Get the Admissions office to get the transfer approved with United HC. Then a bus from the new facility will likely come pick her up.

Good luck to you.
Helpful Answer (2)
Reply to lealonnie1
Report

Ask a Question
Subscribe to
Our Newsletter