Mom (87) left acute rehab and started sub acute rehab post hip fracture. Rehab did not have her meds in place including insulin. Advice?

I worked for a Pharmaceutical middleman. Pharmacies ordered from us. Rehabs do not have pharmacies on site like a Hospital. They order from a pharmacy just like you would.

The Hospital sends discharge papers with meds to the Rehab and the Rehab doctor looks them over and writes prescriptions for them. The prescriptions are sent to the pharmacy who fills them, offsite. If a medication is not in stock, it needs to be ordered from the Pharmaceutical wholesaler. Orders need to be ordered by 8pm to get on the trucks for delivery the next day. Picking and loading are done on the second shift.

So, the Rehab is at the mercy of the pharmacy. They are not allowed to have stock. They only are allowed what is prescribed for each patient. It also has to be documented. Only an LPN or RN can give meds. I don't think Rehabs use Medtechs. That is usually ALs.

Shersher, welcome back. In my experience, this not at all unusual. Not good, not acceptable, but not unusual.

Don't be mortified, it's not YOUR fault. Make sure this a.m. that the hospital orders to the pharmacy were correct. Ours often weren't.

WIshing you and mom well.

Not unusual, unfortunately. And as long as she was monitoring the insulin she could have, in an EMERGENCY addressed this with other insulin belonging to other patients. Hopefully things will improve. I am not certain of the circumstances at the place you are involved with, but I do understand that medical personnel in most places is exhausted and struggling. Not certain what we will do when they begin to quit.

The same happened on my moms first rehab. visit. She was in pain from a stress fracture resulting from a fall. CHF and no meds. I too was promised midnight. Midnight came and went. I went home and got her meds. The nurse was happy to see them when she saw how uncomfortable my mom was. Of course we were told no meds from home when we first arrived.
The rehabs call out the orders to the pharmacy as the patients check in. If the pharmacy delivery truck has already left, then the meds won’t be on it as they make their rounds delivering to all their NHs, ALFs etc. No provision made for late arriving patients. Friday afternoon, the absolute worse time to be discharged from the hospital.
I saw many problems with the med distribution as well. My mom was offered meds for diabetes and she was not diabetic. One day the nurse had an opened suppository going down the hall and said I’m on my way to give this to your mother. It wasn’t intended for my mother. Some issues were small, others more serious. The therapy was great and that was why she was there so we kept trying to work with them. I had Med nurses ask me to look on the chart and verify name of meds for other patients. 😳
She had forgotten her glasses at the nurses station and asked me, a visitor, to help her read the chart.
Late one night I made a surprise visit. After passing the night CNA giggling on the phone in the darkened dining room, I thought well all the patients must be asleep.
I pushed opened the heavy soundproof door to my mothers room and she was sitting up in the middle of her bed hysterical because she couldn’t make the call button work. It had come completely detached from the bed. She had needed help to the bedside commode. No one came. She wet herself and needed dry bedding. Two nights later her CHF was reacting to the whole situation. She wound up back in the ICU. When she was released this time, she went to the rehab at the hospital and did great.
It is a shocking experience and so disheartening to learn that it is not that unusual. Sadly this place was highly rated. I admit the therapy was good and if that was all that mattered it would be one thing but of course, the meds matter too.
If your loved one is physically able, send them to an acute care rehab. hospital instead of a SNF rehab. I found the care far superior. It’s tough but they get better with less incident or that was the case with my mom. The staff is used to dealing with functioning adults and treat the patients with more respect. My mom was in her 90s when this all happened. They have to accept the patient so I was warned by the hospital; SW that the rehab might not accept her. They did and she did great.
I always encourage loved ones to go to therapy but it can be a rocky start. I am sorry it happened to your mom. This was 8 or 9 years ago. No covid to blame it on. Sadly it’s a known issue.
I took my mom to the rehab near her home a couple of hours from the hospital. My FIL had been there for a hip replacement therapy. I had her scripts filled and gave them to the intaking staff. No problem. Not every situation is the same and some patients are in too bad condition to do the more strenuous rehab. I realize this wouldn’t work for everyone.
I think it’s awful that they send the patients family off without explaining what is about to happen. Hopefully the therapy will work out for your mom and she will be up and walking soon. wishing you both all the best.