My mom is in rehab and is ready to come home. Rehab says no. Can I just take her home? She is of sound mind at 92.

The hospital in the town where my Mom lived held her against her will and mine (I was POA and DPOA and also medical proxy at the time). They did not communicate with me....even after I stood at the nurses station and demanded to see the attending. For 4 days this went on,

finally...I brought her clothes...she got dressed, grabbed her walker....and zoom...heading for the elevator....she was leaving. It was all I could do to catch up with her. No papers were signed. Not one follow up call from anyone. Never did speak to anyone in charge of her “care”. That night I discovered massive bruises all down the right side of her body, Easy to see why they didn’t want me to know and didn’t want to talk about why they were keeping her.

many many complaint to the hospital, the state licensing and Federal Medicare.

no one ever tried to get any signature for discharge.

Rehab helps so much. Home health afterwards as a follow up is good too.

Of course, they get tired. It’s really tough work. It starts right after breakfast until late afternoon. Only break is for lunch. My mom worked very hard. Then she followed up with home health.

Hermacj, oh gosh, wish people wouldn't think that rehab is out just for the money. When Medicare pays, the rehab facility, the therapist and facility doctor get much less than if someone younger came in. Medicare does cut the costs quite a bit.

I see from your profile that your Mom has Alzheimer's/Dementia. I realize when one is in a facility they can get delirium which can fog the memory, and every day is groundhog day, easy to lose track. Did your Mom tell you she had one shower a week, or did the Staff tell you that? I bet it was more days then not.

Keep your fingers crossed that your Mom doesn't get another bad cold that she needs to be back in the hospital, as Medicare can choose not to cover the cost of rehab because your Mom was taken out against the doctor's advise the last time this happened.

Oh, you mentioned your Mom had the flu. She will be required to get a flu shot if she moves into a senior facility. Hope your Mom does well in Independent Living. My Dad was in Independent Living and he loved it there. But remember, it's called "independent" for a reason. Hope your Mom is able to do all that is required of her, otherwise you may need to pay for optioned care levels. My Dad would forget to take his meds, so I opted for the Med-Tech service which was an extra $900 per month [or $15 per visit, Dad had 2 visits per day].

Let us know how Mom is doing :)

Hermacj, glad to hear that your mom is moving into IL and selling her house.

I hope that she continues to get the help she needs and improve.

If you remove her or she leaves of her own volition, she will be discharged "against medical advice." You or she (if still competent) will be required to sign papers acknowledging this, since the facility wants to avoid liability for an early, unadvised discharge. The facility does this to avoid being sued for "streeting" someone before they are ready.

And there is a physician who is supervising her care. There is a care plan. A "facility" doesn't just intake patients and then make medical decisions willy nilly. Find out who, may be her primary care MD. Communicate with that physician about your concerns. There are probably factors you don't know about.

Every elder (and even some youngers) who I've seen in hospital or rehab "wants to go home." They think they are fine, until they get home and they are not. One of Medicare's biggest concerns, biggest problems and biggest expenses is for readmission of elderly people who were discharged too soon, who were eager to go home, and who then relapse, fall or have another medical emergency shortly after discharge. Hospitals and facilities are graded on their records in this regard. So hold the phone, don't be in a rush to "get home" before the patient is ready.

I was told if ur in rehab just to get ur strength back, its 3 days of rehab for every day in the hospital. So for Mom she has done her 21 days.

Medicare pays the first 20 days 100%. From 21 to 100 its 50%. Some supplimentals pay some don't. The average ur Mom will owe is about $160 @ day. So Mom may owe $1600. If money is a problem, you may want to tell them she is not able to pay. When Mom went in just to get her strength back, I told them there was no money so they had 20days. She was released in 18 days.

Did u sign her admittance papers? If so, you should have been told how Medicare pays. You should have had a care conference by now. If u don't have POA, Mom can ask u to be there.

I would talk to the Director of Nursing (DON). Tell her Mom wants to go home. Ask her to call the Dr. assigned to Mom and have him discharge her. Rehabs are not prisons.

You may not have enough information about your Mother.
You will need your HIPPA release to find out. Or POA?

Are there other siblings or any other family involved? Who is making her care decisions?

Try talking to her PCP. Ask him/her to discharge her, or to explain why he will not. Get it in writing if possible.

Have you asked your Mother what she wants?

Consider that there could be a medical need above and beyond the concern you rightfully have of paying for care. Find out more.

It just concerns me that the only powers to help her are the hospital decisions, and not the family decisions. That confusion about who's in charge makes her vulnerable to exploitation by anyone!

Hoping you can find out.

Medicare will pay the bill if you take her home. Are you aware that Medicare isn’t paying the full amount for her stay though? They only cover the first 21 days at 100%. Is her supplemental picking up the rest?

You don’t say what she was in rehab for? Your profile says she has Alzheimer’s/ dementia. Have you been visiting daily or are you relying on her to relay the days activities and “she’s ready to come home”. Do you know who her therapists are and have you been attending her sessions? They say she’s not ready to come home...is she back to the her abilities prior to the rehab? In my situation I fought for every week of rehab possible, so please don’t dismiss their opinions without 1st hand knowledge and witnessing her sessions. And once a week shower isn’t that uncommon, as long as they are doing clean ups at the sink the other days. Is it possible she could be refusing more frequent requests?

I’vee found during my husband’s many hospitalizations and stints in rehab that the only way to stay informed is to ASK. Call Care Conferences and when you visit, always ask a nurse or therapist for updates. They will not volunteer information.

The last time my husband was in rehab, he had one shower in three months. That’s not going to happen this time. He is susceptible to life threatening infections and he needs to be kept very clean.

When our loved ones are patients in these places, we need to be proactive and advocate for them.

Before you bring her home, call Medicare and ask if it will endanger her coverage for this.

Are you her POA? Did you do all the admit papers for her (I did them. 100s of them)? Did you put yourself down as her health care contact? Did you contact the facility? There are laws about care conferences, so I do believe those were done. Is your mother completely competent and not at all forgetful, and therefore capable of knowing what days the facility MD visited her?
Communication is a two way street. Generally when you visit you become knows, and nurses will share with you when MD visits, what MD is seeing. As will Physical Therapists, and all that of course dependent on whether or not you do have POA for health care OR your Mom and you got the OK to share info in the chart. Most rehabs are quite desperate to include families as their licensure DEPENDS upon it; I was actually conferenced in to a care plan meeting with my brother and all care givers on a conference call.
Now. To discharge. Has your Mom been discharged? Is she going home alone? She is up in years. Is there adequate supervision and help at home, or is she coming to your home, or you to hers? If she is completely capable mental and physical capacity. Does her chart reflect this? If so I can't see any reason she cannot be discharged home, nor that Medical will not pay.

Yes you have the right to leave against medical advice.

If they are not treating her why do they insist that she stays?

Medicare does pay for services provided. They don't care that you leave before you have maxed out all of your benefits.

I would tell them that you are leaving and taking her with you, they need to do release paperwork and stop billing Medicare when she leaves. Don't let them bully you into keeping her there.

If they try and stop you tell them that you are calling the police for false imprisonment. This is a real thing and very serious, someone will go to jail for false imprisonment.