Hi all, I posted earlier about my mother being at an incredibly lousy sub-acute rehab facility that, out of the 4 days she's been there, has provided NO rehab and is limiting her to 30 minutes per day, 5 days per week after brain surgery. Yes, brain surgery. Apparently the new Medicare rules allow that.
She cannot walk, dress herself, or use utensils. She is getting weaker by the day. I am thinking of discharging her AMA (of the institution, of course) and taking her home to get at-home physical therapy. I am desperate.
Does anyone know how much at-home physical therapy and occupational therapy a doctor can order? We don't have much money at all, but my mother actually needs to spend down her limited assets to qualify for Medicaid. It is breaking my heart seeing her languish in this awful place.
Thanks in advance for your help.
Medicare paid for a PT and OT to each come out 2-3 time a week for a couple of months. He would have gotten more with that extra week inpatient, frankly.
Your rehab may not be the best, but they still have equipment and staff that you don't. I would hang on until the PT/OT starts and you observe it.
https://www.agingcare.com/questions/sub-acute-rehab-says-medicare-only-covers-30-minutes-of-rehab-5-days-per-week-hospital-said-it-would-472709.htm?orderby=oldest
2. The annual Medicare and You booklet used to address limitations on therapy, indicating as well that a doctor could order additional therapy beyond the basic allowance if the situation were appropriate.
I just checked my 2022 Medicare and You booklet, but it no longer provides that information.
So, you could call Medicare and ask them directly. Do it first thing in the morning as the wait time typically has been long when I've called.
3. Put the onus and responsibility on the facility to validate the SW's claim, as well as to provide a plan of care (there should already be one in place) that addresses your mother's care and rehab specifically. In my experience, care plan meetings take place shortly after admission, but no later than one week.
If one is scheduled, try to get a relative or friend to attend as well, indicating perhaps that this person may be involved in post-rehab care and is justified in knowing and understanding the situation. Get to the meeting early, and position yourself so that you can observe facial reactions of the staff and Admins. This will help you determine whether or not the SW is accurate, or is acting as the person to deliver the not so good news.
Be sweet, and don't make it clear you're putting them on the spot. But go beyond the SW, and try to speak to the DON or the assigned doctor. You can also take the approach that you don't see progress with only 1/2 hour a day, and ask if that's the plan for the full time your mother will be there. That's a backdoor way to get them to admit whether or not they think there could be improvement.
4. If you're not pleased with the response, contact the neurologist who performed the brain surgery and raise the issue, and ask for advice on whether or not the plan that's been stated is what he/she would recommend. If not, you have a choice of confronting the staff or finding another facility.
Good luck; I can't imagine how frustrating this would be.
When my Mom had homecare, it was after she fractured a disk and the inserted a "cement" into the fracture to help with pain while it healed. She had OT and PT but for only 2 weeks. Then a friend had it for months.