My brother-in-law was taken to a Rehab Center over 23 days ago- he had a mild stroke. The Center he is in is not taking care of him correctly, my sister is their day and night to make sure he gets the correct care that she is providing. He is ready to go home we have the caregiver and the house is set-up for his care. The Rehab center is making all kinds of excuses why he should not go home. What right does my sister and her husband have to take him home ? Please we need help
"Several sources, including a representative from Medicare, have confirmed that Medicare has no policy to deny payment of hospital charges to patients who leave AMA. Payments are made based on a determination of whether care was medically necessary, regardless of how the patient is discharged."
An article about insurance companies. It was found that Insurance Companies do not pay is bunk. Drs use it to keep patients in the hospital. It also says that some people who leave AMA are usually back in 30 days. But, that is a very low percentage.
www.uchicagomedicine.org/forefront/news/2012/february/do-patients-pay-when-they-leave-against-medical-advice
So it comes down to...you can leave a hospital or rehab facility if you want to with no repercussions from Medicare or Insurances.
I would talk to his primary. If facility feels he needs more therapy or speech therapy homecare maybe able to be set up for that.
TG I have never had to be in rehab. After dealing with Mom I swore she would never go again just to get her strength back. Therapy is just a fraction of their day. The rest of the time they are ignored. Activity time is a joke. I only saw one rehab that went out of their way to have something going on all afternoon. Thats the NH Mom was in. I think the elderly with Dementia just decline. I have seen them look so much better when they are home or in familiar surroundings.
1. Is your brother-in-law able to make his own decisions? If so he can leave anytime he wants.
2. Do you have POA, if he is unable to make his own decisions? If so, you can make a decision when he leaves.
The home cannot keep a resident against their wishes. A resident has a right to refuse care and can leave anytime they choose.
Things to watch out for:
1. If the home feels like a resident is going back to an unsafe environment then they still cannot refuse to let them leave but upon leaving they may call Adult Protective Services to make a visit to ensure the individual is safe.
2. If the doctor refuses to write a discharge order the home may not give you the individual's medication when they leave. They can refuse to do this. If this happens call his doctor and get new prescriptions.
Summary
It sounds like there is a plan for your bother-in-law has a good plan for him when he gets home, he has a caregiver and his home is "set up" for him. There should be NO reason the home does not allow him to go home.
If the home continues to refuse to let him leave you can call the Ombudsman Office, they can help you with this.
Good Luck!
Talk with primary doctor - could make order for in-home care so its not going against medical advice.
If you have not received a return call from a doctor after twice calling - physically go in.
Blessings
hgn
Complain to Adult Protective Services and get him Out, ASAP. They have no right to Hold him there, You have a Right to Sign him Out.
5 days then off to local rehab. She sat in bed nearly 24/7 except for 45" of PT/rehab each morning in their gym. Her dementia seriously increased along with decreased physical strength. The Rehab Dr. (different than her primary Dr.) wouldn't return my calls/messages nor was available @ rehab to meet with me.
After several days of being ignored I announced I was returning her to Assisted Living where she actually had a life, using her walker to go to dining room 3xday,
walking to her bathroom, visiting with residents, etc. = much more physical, mental, emotional activity. The Dr., whom I NEVER met, apparently ordered the discharge minutes before we left. Rehab services are paid for 21 days and we left on day 15. She did beautifully after returning to her home.(AL) Home Health
evaluated her for PT but my snarky sister declined. "Get the Hell out of here. I know how to walk." Bottom line, Rehab wants to bill for 21 days if allowed. Ethics have disappeared from the equation.
My husband was in a rehab facility for 4 1/2 months. It was not like home. Each aide had 10-15 patients to care for. Immediately before, during and immediately after meals, requests to be put back in bed or into a chair had to wait. It’s a different world there. No one patient is any more important than another.
If you feel he suffered true neglect, find the ombudsman in your area and fill out a report.
I’m not sure, but I’d check with his insurances to make sure you aren’t endangering his coverage if you pull him out against medical advice. Call his doctor and find out if he/she knows what’s going on.