My Dad (amputee) fell at home breaking his femur. He's in a SNF for 7 more weeks. He wants to come home. Can he get home health care?

"There are some sticky particulars that I haven't mentioned. He isn't biologically related to me. I call him dad etc. Our families were very close growing up. We are his caregivers."

I saw on your profile that you are 42, correct? Do you work outside the home? Are you his POA and/or HCPOA? Does he have any family?

What is his financial situation? Could he afford all the care he would need at home?

Your gut is telling you that he should remain where he is. Follow it.

Medicare pays for "in home" if discharged from a hospital or rehab. They supply PT or OT a few hours a day. An aide maybe will get 2 or 3x a week for bathing. Not sure how much xtra time he could have. Dad will not be getting an aide fulltime unless he pays for it. And when he has reached his plateau, the agency will discharge him. If you are not willing to help him with toileting and other things, he needs to stay in rehab. As said, you can claim "unsafe discharge" that there is no one to care for him.

When all is said and done, he may need 24/7 care. If so, decisions need to be made. Should he go to an assisted living? Should he transition into Long term care w/Medicaid paying for his care? Or does he hire aides to care for him in his home, which can be a challenge. Finding the right people that are on time and show up.

Home health care probably would serve him, but it wouldn't be anywhere close to the level of care he could get in a rehab facility.  

It wouldn't be indefinite; the nurse who performs the intake assessment establishes goals and plots a timeline.   Unfortunately, that goal might not include care at home until he's able to be weight bearing.  

He would more than likely need a hospital bed, as well as commode, and a lot of attention just to get through the day with less than the staff that's available to him now.

Another fact stands out as a major issue:  right now he apparently isn't getting lower body workouts, understandably b/c of the fracture.    That's understandable.   I question whether home health care would be prepared to initiate that during the course of in home treatment, and he absolutely needs that in order regain function.

When in rehab, he likely will eventually learn to walk on the injured leg, but it will be a different situation with unfortunately only one leg.   

BTW, does he have a prosthesis for the amputated leg?   Is he a Veteran?  If so, he could get more extensive treatment at a VA - they deal with amputees  a lot more than regular hospitals do.

I do hope you can convince him it's not in his best interests to check himself out AMA.   You might also ask the DON or attending doctor to explain to him what would be involved, but just as a preview of what he's facing, w/o mention of his desire to come home next week.    They can just "brief" on what the plan is.

You might be able to put a stop to him checking himself out. If you inform the facility that he would not be safe at home. Safe does not mean he might fall, but "safe" means would he get the same level of care in order for him to not develop pressure sores. or injure him or yourself in the process of caring for him.
It also means that he might not be safe if YOU were caring for him without all the proper equipment that you would need to move him, transfer him.
He might not be safe unless there were at least 2 people helping him transfer even with equipment.

He almost certainly cannot get enough home health to adequately serve him being non-weight bearing. Your Dad would be confined to w/c. While this may work for him if he is in all other ways very capable to be alone at home (which I assume he is) with some minimal help with revamping his home to adapt to w/c living, he would nevertheless need more training in living with a w/c. What your State will provide to him is individual to your State. It is time to speak with the careplanners for discharge planning to deal with your father's either "realistic" or "unrealistic" behavior in his own plan for home going. Contact the Social Worker at his rehab on Monday and speak with them.
If Dad is competent and does indeed do an "AMA" or Against Medical Advice discharge on his own he may be in enough trouble soon enough that he will be re hospitalized.
I think crucial here is that you should NOT enable him in this behavior. Tell him that you will be unable to help him in any way if he does this unwise and uncooperative action.

He probably CAN check himself out AMA---but as far as getting the same level of care as he'd getting in a skilled rehab--that isn't going to happen at home.

UNLESS--he has a LOT of money to burn. You can BUY just about anything you'd want/need, but Medicare only covers so much and no more. There's a LOT of 'down time' where he would be alone, and doubtful he can do much for himself. The fact he is not weight bearing is only one small part of his whole care need. He really needs 24/7 access to care. And you know that.

Maybe whomever is his POA needs to step in and stop this plan before it gets started. (But, I bet he doesn't HAVE a POA, so he's doing this all on his own, right?)

Stubborn doesn't seem to cover the dynamic here. If this were my dad, I would simply refuse to help him make this ill-conceived move and let him see how hard it will be to function alone at home with CG's coming in.

Without help from somebody, he will not be able to navigate the waters here. I sound mean, but just b/c our LO's WANT something, doesn't mean we have to move heaven and earth to get that for them.