I'm in a rehab long-term care facility. I was prescribed pain meds for chronic pain. Can the facility change what the doctor prescribed?

Truth be told, every narcotic pain med prescription written is being scrutinized these days.

Maybe they don’t offer that particular medication in that center’s formulary and they had to write a substitute.

I encourage you to make an appt and meet with the rehab doctor to tell him your concerns.

I expect the rehab facility has its own qualified and licensed medical practitioners who would be fully competent to revise and adjust your prescription. Have you tried asking who signed off the new prescription? When you say "they" think you no longer need the same level and type of pain relief, who is "they"?

Wherever you are living, you're still a patient and you still have a professional relationship with your doctor. If you're not happy with your treatment or medical care, that's who to speak to. If you're not happy with the *doctor*, then there are other things you can do about that.

If you are in a rehab facility, then there's a doctor in that facility that is your doctor while your are there. They take over the prescriptions.

The facility doctor has the final say and can override a surgeon or primary care doctor's orders. I just appealed a facility decision for my sister and was denied bc Medicare accepted the facility over surgeon orders for a double amputee. The system is broken and it's not in favor of the patient!

Talk to the doctor AT the rehab. He is the one changing your meds at this point. You might need to call your own doctor and have him get in touch with the doctor over your care at this point.

I know that opioid pain medications are being loked at very closely these days, and the way they had historically been prescribed has been called into question by research. You don't mention if the meds you're taking for chronic pain are opioids, but I've read that this class of medication is advised for acute short term pain (as in after surgery) or for intractable pain in conditions such as end stage cancer. They should no the used for chronic pain, but other alternatives should be tried (other meds, acupuncture, even marijuana if it's legal where you live). It would be well worthwhile speaking with the facility doctor, who's presumably the one changing the medication, to see what their plan of action is. Many pain meds can't be quit cold turkey but need to be tapered. Have you ever seen a pain specialist? If not, maybe you could get a referral to one. Best of luck!

My own experience in a rehab center was also that the rehab doctor/facility was in charge.of medication and it was not an ideal experience. Prescriptions might be changed and actual delivery of even those medications was poorly managed. Being in a rehab facility implies that you are participating in a rehabilitation with a goal of enough improvement to leave. When you say "LTC rehab" it sounds more like extended skilled nursing care in which case the facility doctor has final day in medications.

When you go into rehab you are under the care of the rehab doctor. You should have a talk with him/her regarding this. Ask for a meeting.

When my mom was in rehab after her stoke the facility had a hospitalist, like the hospital did, on duty (it was really a group and they took turns being on for 4 or 5 days at a time as I recall) who was essentially her PC while in rehab. My mom is diabetic and one of them decided he knew better than the doctors who had been working with her and managing her care for years and had a much better plan for managing her diabetes. One of the others decided to change around her depression medications (again she had been on them and managed by both a therapist she saw weekly prior to this event and a prescribing psychiatrist who saw her regularly and worked with the therapist, she had been seeing them both for 10 years or more). When the first change was suddenly made I insisted that they discuss any new plans with me and her regular specialist and or PC before making any changes from then on. I then contacted each of her regular doctor's myself about planned or discussed changes and gave them the contact info for the hospitalist as well. I made sure I heard from the doctors I knew and trusted about any changes and only agreed if they concerned but mainly I found that once I put my foot down about her regular team being consulted before medication changes were made that either happened or the hospitalist lost interest in experimenting on Mom. I shouldn't be so snarky, I do think they each had her best interest in mind and believed they were making positive changes however they weren't considering the variety of other factors that may have gone into the plan she was on and the factors that would come back into play once she went home, they were messing with medications that take time to fully know the effects of changing and a fine balance that took years with constant tweaks to balance. They were hospitalist though and in many cases if not all, only had experience with patients in the very controlled environment of a hospital setting with nurses administering meds and daily vitals. I imagine they aren't often questioned by patients and families either and often send patients home on programs that just don't work for them in their home environment which is why so often when you make the rounds to your personal physicians again (something they have you do when transferring care back to your regular team) adjustments are often needed or made all over again. It is infuriating and I can see how it might cause real issues sometimes, all reasons we as caregivers and concerned family need to pay close attention, ask questions and advocate for our loved ones during these medical event's, IMHO.

In your case do advocate for yourself, insist your regular doctor be consulted and whoever is making the changes explains the reasons and details of them to you until you understand and feel comfortable with the plan. I would urge you to include a trusted family member or friend as well if at all possible because this is really too much for a patient to be doing all on their own.

Normally the physician in charge of your care in your facility, if that is not your own doctor, would be the one to adjust pain medications as he or she thinks necessary. Hopefully this MD discussed adjusting the medications with you?
If your own physician is the one still caring for you, and not the facility doctor, then the prescription should stand as he or she wrote it. However, if the facility feels that you are having side effects or symptoms they may have their own nurse call your doctor, requesting that the prescription amount or timing be changed.
You almost cannot know exactly what happened here without asking how this happened.
I hope you are not experiencing more pain.