My husband was hospitalized for Sepsis which weakened his entire body. Upon release he was sent to rehab for PT and OT. He was tested for c-diff just today since he has not been able to eat without food running right through him, literally. The test results haven’t come back yet. Also the PT has said that his heart rate is all over the place and an EKG was ordered just today. Well today, as soon as I get home from visiting him, the social worker called and tells me he’s scheduled to be released in two days. Then she said I have the right to appeal. Are you kidding me? How could he be OK to come home. Is it standard procedure to have to appeal to get continued coverage. He went in rehab on Sunday and today is Wednesday. They want to discharge him Friday. He is 83 years old.
Good luck on the appeal. Some on the forum have done it and won and hope that they are around to walk you through; I am sure there must be key phrases to use like hospitalization key phrase being "unsafe discharge".
Hope you will update us.
He is in a skilled nursing facility. He was sent there to build his strength up so that he could return home. They did tell me that if he does indeed have c-diff they would confine him to his room as it is highly contagious and provide the proper treatment. The PT did work with him but wanted to find out why his heart rate was not reacting as she thought. He hasn’t plateau as he hasn’t even completed all the goals they set yet. I will definitely appeal and stress unsafe discharge in addition to the developments that took place while I was there. Thank you for your advice.
Based on the issues he has...it sounds like rehab isn't going to work....heart rate all over the place.... Medicare bases their decision on the medical assessment of the facility.
Or get hold of the Director of Nursing and ask her directly what she would do if this was HER loved one.
I would talk to the DON tomorrow and find out specifically the purpose for his stay, whether that's been met and/or still exists, whether or not the treating physician at rehab plans to recommend home care (which I think sounds necessary), and why they feel he's ready for discharge.
If you can't get to the DON, type up the notes (then they know you're serious) and ask the social worker to locate the appropriate people and get answers.
You could also ask her for brochures on home rehab, PT, OT, nurse, aide, etc. and make sure that she arranges for your chosen home rehab company to start either the day of or the day after he returns home.
I've been through similar situations when I thought my father was being discharged too soon. I didn't investigate an appeal, b/c at that time I was getting fed up with their lack of interest in his care and didn't feel there would be any benefit to being there any longer. But I did make sure I got a referral for home care.
I can understand how frustrating this must be for you. It takes awhile to learn how to play the games of ensuring that you get the care you want.
And as to appeal, I'm only familiar with appeals from hospital discharges.
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