When and how can a patient be discharged from NY rehab/SNF center to home?

While another poster said rehab would try to keep your mother as long as possible, my personal experience has been the opposite. There is usually a maximum mandated length for a rehab stay after a particular procedure. Twice I was kicked out of rehab after 5-6 days because they thought I was ready to leave and have at-home PT and OT; I wanted to stay a little longer.

The other posters are correct re having a care conference, but if your mother is ready to leave in the opinion of the relevant staff, she'll be encouraged to leave. If she is not ready in their opinion, they should explain why. If they recommend a few more days, it's probably best to go along with the recommendation. If there is major disagreement, the alternatives for immediate outpatient therapy should be discussed so your mother can decide what she wants to do. I agree that she should be very certain if she wants to leave AMA if she doesn't want to stay longer, and she should be sure that she can get outpatient therapy, as well, before leaving AMA. I left the hospital once AMA and there was no problem with Medicare. Another time they wanted me to stay another day and I told them I would leave AMA regardless, which I would have done. I think I called their bluff, because they ultimately agreed with me on under what conditions I could leave successfully, and I did.

HAPPYHAKKA; Your wife should request a care meeting.

https://www.agingcare.com/questions/discharge-plan-from-inpatient-rehab-in-new-york-any-advice-480745.htm

You asked a similar question yesterday. If she is on Medicare the first 20 days are 100% paid by them. After that 21 to 100 days are 50%. If your secondary insurance won't pay that its like 160/170 you will pay out of pocket a day. Can u afford that? If not, thats what you tell them. They should have called your secondary to see if or what they will pay, predetermination. Your wife should have signed financial paperwork insuring the Rehab would get paid. On that paperwork, it should say what her share will be per day.

They will try and keep her the 20days. I told the finance department when my Mom was in Rehab that there was no money for after the 20days. She was released in 18. At the time she was not a candidate for Medicaid and I wouldn't have applied if she had been.

Yes, if she walks out AMA there could be a problem with ur insurance in the future. A forum member said a LO did this and ended up back in the hospital for the same thing they were in Rehab for. The insurance company would not pay for the second time. Also, when going AMA they will not give the patient scripts or set them up for "in home" care.

If your wife has not had a care meeting she needs to demand one. I think ur suppose to have one within 7 days. She then tells the staff present, she is ready to go home with "in home" therapy. Rehab is not a prison. You actually can refuse it. Use the money angle.

Has your wife participated in a Care Meeting with her team?

The MD will consult with the PT/OT team and decide if further therapy can occur at home. If the MD doesn't feel that is wise he/she will not do the discharge as it would constitute an "unsafe discharge" something his license could be called into question over. He/she will explain fully to your wife why he/she believes it is unwise and to you also if you are MPOA.

If your wife is competent to make her own decisions and understand that she is risking injury to herself then she can sign out AMA (Against Medical Advice). Rehab and SNF isn't jail. People who are competent are free to make their own decisions, even ones that may be unwise.

Wish you the best.

Is she truly ready to come home in your opinion also? I’ve only dealt with rehab/skilled nursing once when my mom broke her hip but my sister’s friend worked in admissions in the one she went to. From what she told me SN will keep you for as long as your insurance will approve. My mother happened to have really good insurance that paid 100% for 30+ days and that is exactly how long they kept her. I was not fighting it though and neither was my mother. Have you spoken with the discharge planners there? Do they have weekly care team meetings?