Why is the rehab my mom went to refusing to let her come back?

I'd speak with someone else at that same place. It's possible, through no fault of her own, that your mom reminds the person, you spoke to, of someone or something, that, fairly or unfairly, rubs them the wrong way.
You're lucky if your mom is easy to get along with. My mother was hateful and spiteful her whole life, only getting along with my dad long enough to have children. Mom getting older, arthitic, and somewhat demented hasn't helped, so it's difficult to find anyone, that can even get her to do the simplist, most effortless exercise, so usually, after 3 or 4 paid visits, with Mom satisfying her need to "feel" in control by not cooperating, even rehab people, who might be unscrupulous enough to get paid for no progress, tell us we are wasting time and money, because they can't do anything with her and, they don't come right out and say it, but it's obvious, that they can't stand the aggravation and frustration of dealing with such a hateful, spiteful, and melancholy person. If she was pleasant, they'd at least be able to make small talk and maybe eventually "get through to her".

Hospitals & rehabs will not get paid for a re-admission for the same problem.

I beg to differ. It may depend on insurance. (Although I would note that she said the NH wouldn't take her mom, not that insurance refused to cover it) Before we learned my husband had a urine retention issue, he had two bouts with toxic encephalopathy (due to his lithium not getting passed out of his system). He was admitted to Hosp & NH after both times.

HOspital staff and. Drs. do their best to work within a limited availability
of staff,facilitiesand beds. Faced with anger from hospital management
or doctors when they admit long term difficult patients, like alziehmers
or the elderly with frail aged problems who use up too much bedtime and staff
they in the end put up barriers to not acceptl these patients, sending them away
for families to cope with the problems themselves.

It is often not pissible for people to do this lng term without their own mental
and physical health suffering.

But the staff at hospitals are in the end loyal to the will of the hospital managers
as opposed to the patients, because they want to keep their jobs.

So hospitals,nurses and social workers, can come up with a lot of ways
to stonewall patients at the admission desks, in fact they are experts at it.

You can contact your local ombudsman and request their assistance. Explain the situation and see if they can help. Their role is to be advocates for residents.

KimberlyP

Your choices may be limited, You may not know, but rehabs,skilled nursing,etc pay a referral fee to hospitals as gratitude for getting a new customer. Depending on how much they pay, it may take more than 2 weeks to recoup their costs, plus make a profit as well.

jmacleve

It is in the best interests, financially, to have her moved to rehab, since rehab will pay a referral fee to the hospital.

Chi mongerreading your poatmakes me glad I refused to go to rehab. At the time i knew I was far too ill to e able to tolerate the level of self sufficiency and activities that would be expected of me so I just went home and spent my time in my night gown till I was strong enough to start doing what I was able. I did not realize I was being "dumped" For the record I was re-admitted to a different hospital three days later and rehab was never mentionedd again.

TooYoungForThis nailed it.
Acute hospitals often dump patients into NH's or rehabs, to open up beds...they will write transfer orders with entirely wrong orders, just to get the patient transferred....prescribe all oral meds, self-transfers and other orders for patients who are bed-bound and cannot swallow, who actually still need acute hospital care. Instances like that, killed Grandma prematurely.
Too often, I've accompanied patients to various E.R.'s, only to be faced with ER Docs who refuse to listen to reports of the actual condition of the patient; those Docs assume conditions based on exterior appearance, order wrong X-rays, wrong lab tests, wrong everything, then bustle the patient upstairs to admit.
Social Workers will tell people there are "no rehab beds" for all kinds of reasons, some are not true, others are. It's very like store employees telling consumers "that item is no longer made", when the item really is still made, but that store no longer carries it...they want you to buy what they Do carry, instead.
The broken systems health care workers must contend with, are madness.
If someone has care levels that require too complex care, they will refuse the patient. If insurance dislikes the diagnosis codes, the facility can refuse the patient.
If the patient has mental issues, the facility will refuse, but give other excuses why.
If the patient has alcohol use problems, facilities will refuse.
If the facility lacks staff, they can refuse admits.
If someone blows against the wind on the wrong Tuesday in the 13th month, facilities can refuse to accept the person.
So do PCPs and acute hospitals...systems play "hot-potato" with elders all the time.
Docs, nursing staff, ward clerks, etc. can all make charting errors that can block getting proper care and coverage! Unfortunately, most folks do not know about that, assume those are always accurate....but medical personnel are humans, and make human errors.
NH's that increase the level of acuity of care they can offer, seldom staff to properly cover that [like one NH I worked, where they upped-their acuity rating, to allow IV's, for instance, but kept same level of staff].
It might help to go up the chain of command at a facility you want her admitted to, to learn why they refused admission, instead of being stymied by the Acute Hospital Social Worker, who might be having a bad day, or might not have proper data to make a decision with.
Be persistent asking questions to gain clarity; it might disclose inaccurate charting, inaccurate diagnosis and billing codes, etc., poor communications, which might be easily cleared up in the process.
I hope you can find out why care has been denied, and can get that resolved!

this is a political issue also.
In Australia, the government doesnt provide enough beds and
staff for aged care needs. In the newspaper this week hey said the government
had pulled 3billion out of aged care funding.
Do you have what they call respite care for carers in your area, the social workers
here, the government Acat socoal workers can give you a form that grants you
so many weeks respite care.

The hospitals in general in Australia, are underfunded, and they are often hard
pressed to actually have one bed available. So when you arrive at the hospital
with a chronically, ongoing aged person needing looking after, they will do
their best to turn you away and turn you into the caregiver, plus nurse
at home.

I had this talk with my Dad today, I said "Dad, we have to ring assisted housing,
and get your name put on their waiting list for a unit for you". You've got to plan ahead". If your name comes up in 3years, and you are still managing at home, they just put your name further down the list" until you may actually need it."
The point is that once your name is on their list, it is never taken off."
Dad has some early cognitive problems.

Dad doesnt think he needs to do this, he says I will just call you. Hes quite prepared to put all the worry on me, which I dont intend to do to my own children.
I said Dad, " I will have to take you to the hospital, and they might put you in
a place with a bad reputation, because that's, the only ones they have readily available.". He said, "I dont give a buggar as long as they feed me?"

So he is ignoring his own responsibility to help me do this, selfishly just not
wanting to be bothered with it. I didnt say to him,but if I do have to take him to the hospital,
regardless of whether they admit him. I will be leaving him there. Because the one thing I refuse to be coerced into is living with him and being made to provide nursing care.
I do non live in carer things for him, which I have done for the past 15years,
but I will not live with him, he drives me crazy after a day out with him.
And I dont mean that lightly.

So it will be a standoff between me and the hospital if he needs any longterm nursing or around the clock care. They can put me in prison, but I know my wellbeing
and mental health would go downhill very quickly, So, they will come up against one determined person. Im all so fighting Dad because he would be more than happy for me to spend the last decade of my life running after his every need.

At NH's, there are rehab beds that are strictly Medicare beds. Or there might be a wait list for the rehab bed.

Hospitals routinely discharge to "rehab"----this is their way of clearing out beds of people that are not ready to be discharged home but can get the same treatment that they got in the hospital to make room for someone else to fill the bed & for the hospital to make more money from a new admission.

Is your mother oxygen-dependent at home? Why did she refuse to "take oxygen home with her"? (I find this statement strange because rehab facilities don't send people home with oxygen---oxygen is usually delivered by a home medical supply service.) Why does your mother require one hospital stay every year? Does she get pneumonia or an exacerbation of COPD? Perhaps she needs better control of her COPD in the form of steroids, a bi-pap machine & oxygen
at home to prevent a hospital admission. You should inquire about it with her doctor.

Legally, people can refuse anything they want and nobody can force anything on them. People are non-compliant all the time, for one reason or another.

One thing I do know is that there are strict limits on payment by Medicare & secondary insurance when there is a re-admission for the same thing within a certain amount of time. Hospitals & rehabs will not get paid for a re-admission for the same problem. Therefore, doctors try everything in their power to avoid re-admitting patients with the same diagnosis so they & the facility will be paid.

Everything boils down to money, in healthcare and everywhere else. Morals & ethics don't matter. Doing the right things doesn't matter. It's all about which insurance is going to pay the most for the stay. It shouldn't be that way, but it is. Rehab facilities and LTC do not want to take patients on a lot of medications---especially brand name, expensive medications---and they want patients that need the least amount of care, so that they spend the least amount of money & collect the most amount of money. It's called a "wallet biopsy". That's how rehabs & LTC places function.

Welcome to America!!

Kim, your mother has lung disease and ends up in the hospital, it seems, because she is non-compliant at home with what she needs to do to stay out of the hospital.

It sounds like the underlying issue is that she needs a higher level of care; someplace where her oxygen use can be monitored and encouaged. Try to see the big picture here.

... as Ive said and asked further back, is/if her need for rehab is such that can be done at home thru in-home visiting rehab. Any place that' is refusing service or treatment for less than fair or expected reasons is a place that should be investigated, but certainly never allow your loved one to return and make sure they don't due to the fact of not trusting the facilitys motives. (You can also run the event by an attorney)

Not Taking oxygen home should in no way under anyone's terms or regulation ever ban someone from ever using the facility again. There is a difference between rejecting taking something home with rejecting the oxygen during her stay. The only consern of the rehab should have been what she did while in their care, period.

No point in sending her to rehab if she is non-compliant. She has to be motivated to take meds, use oxygen and do the PT. Yes, it is legal.

I left the rehab a hour asking for a face to face meeting and they called me to say my mother is non compliant because when she left the rehab she refused to take home oxygen. I don't think that warrants banning her. Is this legal?

Here were I live rehabs are part of the long-term nursing facility. I just went thru placing Mom. The hospital Social Worker suggested a rehab that was an half hour away from my home. I asked for one 10min away. She was placed in the long-term unit until a bed was available in rehab. The only time I've heard of a rehab not excepting someone is because of insurance or they have no room available. Iss the reason ur Mom needs to be in rehab is for therapy? My Mom will not go back to rehab if it's only for therapy. Therapy can be done at home or the AL they r in. Mom would be in her therapy for maybe an hour or two a day. The rest of the time she was in a wheelchair. I was told she hit her baseline. She would need assistance to walk. Really, before her UTI she walked, with a walker, all over her facility. You can refuse rehab and ask your family doctor to have her evaluated for home OT and PT.

The rehab facility does not have any beds---I suspect there is a waiting list for a rehab bed there.

"Insinuating" that the rehab facility "is refusing to take her" can mean a multitude of different things. They certainly can refuse to take her if there is no bed available. You don't say who was doing the "insinuating". A rehab facility wouldn't---and legally cannot----refuse to take your mother because she refuses certain treatments. But, they can refuse to take her if other people on the waiting list have better insurance, will be admitted for a longer period of time & require less care than your mother does.

Quite honestly, doctors have no idea which facilities have beds and which don't. It is not their job to call the facility to find a bed for your mother----that is the social worker's job. I wouldn't put much faith into what the doctor said----you also could have heard him incorrectly.

(Please excuse typos and incorrect wording such as; "Medicare/ Medicare " ...should read "Medicare / Medicaid "

....if your mother is on Medicare /Medicare her assistance coverage (as anyone whom holds that Medicare/Medicare) allows extended care rehab for specific amount of days only and directly from hospital discharge. Problem is, Medicade/ Medicare does not "put out big bucks for these high cost facilities... so the facilities often reject those on assistance especially if the individual needs repeat rehabilitation as you've explained your mother does annually. Now,if your mother has a private insurance rather than Medicade/Medicare and they rejected care, it's very likely that insurance had either paid slow or was problematic the last time/s she was in. These rehabs and nursing homes and assisted /skilled etc facilities are not there to help, they are there to make money for their corporate investors. That is not opinion, that is a well known business fact. Back to your mom; many times such as COPD extended care facility rehab is actually not needed .. (meaning if she honestly does not need the in-facility rehab for her particular needs) .. let your mother rehab at home .. Meaning sign her up for "hospital discharge in-home rehab" ...make sure this includes both physical and occupational in-home therapy rehab and also sign her up for in-home visiting nurse. Those types of after hospital in-home rehab services are also allowed thru Medicare / Medicaid and private insurances. They will actually last longer and offer longer rehab care than the 15 days extended care facility time limit. It's many times more beneficial for the patient to rehab at home. She or you can set the times for therapy and nurse arrive per day to fit your schedules. But she can have in-home occupational and physical therapy twice a day every day of the week if she would like and visiting nurse anywhere from 2 to 4 days visits per week. If she does not need life saving 24/7 every minute care, then in-home rehab may work for you and her far better than any facility rehab.

My husband was evicted because he was a big guy (260 lbs.) and if he fell they couldn't pick him up. Only 2 women there on night shift. Now he is in a lovely place just two blocks down from the firehouse. I they need to, they can call and the wonderful firemen will just drive up & pick him out of the floor. No charge. BLESS THEM.

I assume your Mom has medicare in addition to her other insurance. medicare is usually primary and the addition ins picks up what medicare won't pay. Some facilities don't take medicare under any circumstances. Beds are very scarce in using homes and a patient often does have to wait a long time to get one.
Many are unable to cope with serious medical situations such as tube feeding or IVs. They simply don't have the quailed staff to do these things. Of course there are behavioral issues, mental illness, and psychotic behavior. Gather your Mom is only difficult about certain medications. Very expensive meications are also an issue as nursing home are paid a standard rate daily for every patient and theses meds may cost more than they can afford. Patient placement is not a simple issue so you have to find out what is really behind this decision including talking to Mom's secondary insurance company.
Did mom make satisfactory progress last time in rehab? That has to be documented for medicare say when she arrives she can only transfer from bed to chair but within the allotted time she can walk 100 feet but if she won't do PT and refuses to try Medicare will no longer pay. nfortunately it is not as simple as some insinuating that the facility did not want her.

My first thought is the likelihood of a behavior problem. Some facilities will refuse someone with serious behavior issues if it's to protect the safety of others and the patient themselves. The first thing to check for is to see if there was any possibility of a behavior issue that you don't know about, because if the behavior was very disturbing or even dangerous, I don't blame the facility for refusing her. If they don't think they can handle that type of patient for some reason they don't think they're cut out for it, they'll refuse if she happens to be a risk.

Another possibility I thought of is the possibility that she won't cooperate with her treatment plan caregivers. If you put someone into a treatment plan for rehab and they won't cooperate to get well, there's no use wasting your time if they just don't want to get better by following a treatment plan.

Another thing to consider is what is the doctor was mistaken about the bed availability? People make mistakes all the time, that's just part of being human.

Is it also possible that her insurance will only cover so much for her rehab?

Definitely do your homework and find out some things. What I would do is get a hold of a supervisor at that facility and start probing. Find out why they refused her and ask specific questions

In my situation, I had family members who made the nursing home staff extremely uncomfortable and ordered them around and made unfounded accusations of neglect and fraud. They harassed and constantly criticized the staff, though in their eyes they were just "taking care of Dad". (IMHO, it was a control issue.) I repeat - UNFOUNDED accusations. My father had a crisis that brought out all kinds of mental illness based on our less than pleasant childhood, and it was reflected in their behavior. These members eventually convinced my father that I could no longer give him the attention he needed and that they needed to take over his care. Dad gave in, and POA was transferred to them. They tried to move him to another facility, but were refused without reason. From what I heard, they had grilled the new facility's staff, talked to patients, even looked into the cafeteria. In short, they were carrying on with the new staff the way they were with the old staff. You may want to make sure that there are no family members sending up red flags with the staff. I know that I wouldn't want to take in my father, based on the way my family was treating my employees. It would just be asking for trouble.

The question of who did the 'insinuating' really matters. The social worker at the rehab centre said there's no bed and there won't be for a few weeks. Well, maybe there is no bed and there won't be for a few weeks. But who was it who started the rumours, someone who would really know?

The thing is, I'm not sure it's worth the bother of challenging this.

It's a shame there isn't an alternative within reasonable travelling distance, but if your mother is going to be there for only a fortnight it's not the end of the world - you can get away with not visiting, just calling and sending cards and encouraging messages.

I realise this sounds sad, and of course if it were my mother I would want to visit too, but it is only a fortnight. As long as the care is good and her doctors recommend it for her convalescence, try not to get upset about how far away it is because you'll put your mother off it and she won't do as well as she might there.

Unfortunately, facilities can discriminate at the door. What I mean by this is they can refuse to take anyone for any reason prior to admission. Often times they won't tell you the real reason for denial. Once the admit someone they can actually do a emergency discharge if the person has been there for under 30 days for any reason. Once someone has been at a facility for 30 days there are very strict guidelines on how and when someone can discharge a resident.
It will be nearly impossible to find out why the home is refusing to take your mom because they don't have to disclose that information. Most likely if anything they would simply tell you they don't have room or they can not meet her needs. Either way your only option will be to find alternative placement.

How is it "eviction" if she didn't live there?

123cher really hit a nerve with me. My husband was in bad nursing home. They insisted his gastric cancer had gone to brain. I thought he was being drugged. I got him transferered and in two days he went from total disorientation to teady 26 pages of our income tax files. I was told he would have to remain that facility the rest of his life. In two weeks he was home. The cancer dod not metastasis to his brain or anywhere else. He lived over a year and died from sepsis contacted at a rehab facility , not from cancer. During that time we were hounded with Hospice, Hospice, Hospice. Autopsy confirmed cancer had not spread.
I hope and pray KimberlyP finds facility that will provide her mom with good care and some TLC for both her mom and the family.

Take a look at the patient's diagnosis code numbers , write it down, look it up and get it translated. If there is any psychiatric DSM code in there, the rehab can't take them per state health laws, unless they are licensed to handle psychiatric cases (psych MD on staff). The facility you want may only have a limited mental health license.

This is considered an eviction