Wife has been in a rehab center for 2 weeks following a hospital stay for spinal surgery. Her health has improved sufficiently that she no longer needs the services provided, in her opinion. She would like to go home for outpatient therapy. How can she get the facility to consider a discharge without risking AMA discharge ?
The other posters are correct re having a care conference, but if your mother is ready to leave in the opinion of the relevant staff, she'll be encouraged to leave. If she is not ready in their opinion, they should explain why. If they recommend a few more days, it's probably best to go along with the recommendation. If there is major disagreement, the alternatives for immediate outpatient therapy should be discussed so your mother can decide what she wants to do. I agree that she should be very certain if she wants to leave AMA if she doesn't want to stay longer, and she should be sure that she can get outpatient therapy, as well, before leaving AMA. I left the hospital once AMA and there was no problem with Medicare. Another time they wanted me to stay another day and I told them I would leave AMA regardless, which I would have done. I think I called their bluff, because they ultimately agreed with me on under what conditions I could leave successfully, and I did.
You asked a similar question yesterday. If she is on Medicare the first 20 days are 100% paid by them. After that 21 to 100 days are 50%. If your secondary insurance won't pay that its like 160/170 you will pay out of pocket a day. Can u afford that? If not, thats what you tell them. They should have called your secondary to see if or what they will pay, predetermination. Your wife should have signed financial paperwork insuring the Rehab would get paid. On that paperwork, it should say what her share will be per day.
They will try and keep her the 20days. I told the finance department when my Mom was in Rehab that there was no money for after the 20days. She was released in 18. At the time she was not a candidate for Medicaid and I wouldn't have applied if she had been.
Yes, if she walks out AMA there could be a problem with ur insurance in the future. A forum member said a LO did this and ended up back in the hospital for the same thing they were in Rehab for. The insurance company would not pay for the second time. Also, when going AMA they will not give the patient scripts or set them up for "in home" care.
If your wife has not had a care meeting she needs to demand one. I think ur suppose to have one within 7 days. She then tells the staff present, she is ready to go home with "in home" therapy. Rehab is not a prison. You actually can refuse it. Use the money angle.
If your wife is competent to make her own decisions and understand that she is risking injury to herself then she can sign out AMA (Against Medical Advice). Rehab and SNF isn't jail. People who are competent are free to make their own decisions, even ones that may be unwise.
Wish you the best.
Thanks