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Needhelpfor1 Asked March 9, 2024

How do we stop Kaiser from sending my loved one to a horrible post-acute facility after a stroke?

I asked Kaiser for the list of contracted post-acute facilities they use. I was then informed that if I did not choose one of the three facilities they have and appealed the decision, the cost of her stay at Kaiser during the appeal would be on her to pay. Does this sound accurate? 

lealonnie1 Mar 9, 2024
Sounds accurate to me. Kaiser is giving you a choice of 3 post acute facilities for stroke rehab. ALL of them are horrible??? If you appeal, and it takes a week for KP to reach a decision, the hospital bill for that week would be on her because you were given an alternative and chose not to take it. And if you lose the appeal, your loved one is going to one of those 3 KP approved facilities ANYWAY.

Unless you're brand new to KP, this is how they operate and always have. You use KP facilities according to KP rules. I'd pick one of the 3 facilities offered and know that KP isn't likely to send your loved one somewhere where they won't get PT and OT.....because they'll wind up BACK in the hospital with KP footing another bill. Their goal is to get the patient cured or rehabbed properly so they're LESS of a financial burden to KP.

AlvaDeer Mar 9, 2024
Yes, a person can no longer stay in acute care hospitalization when it isn't needed.

If your Aunt can afford an ALF or MC facility then you can assist in choosing one to your liking. However, if this is insurance covered in any way, say a rehab or SNF, then Kaiser is in charge of choosing what facilities they use in this area.

Hospitalization for someone not requiring acute care hospitalization will not fly; an appeal to have her stay in hospital will not work. Kaiser system has excellent Social Workers. I would contact and ask for social worker involved here IF you are POA for your loved one.

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JoAnn29 Mar 9, 2024
We have people who use Kaiser may give u better info. My Mom wasbon Medicare with a suppliment and I was given a choice where to place her.

Geaton777 Mar 9, 2024
If she lives in a populated area it may be that the good places are full.

A family friend who was run over by a truck had to go to a facility 2 hours away from his wife and home because of the extensive damage to his legs. This is in FL, "Heaven's Waiting Room"... so, lots of demand plus a shortage of medical workers plus he needed a certain type of care that may not have been available locally.

If you're willing to travel farther you may have more options? Or, does she need a special type of care?

NeedHelpWithMom Mar 9, 2024
My dad was in a really crappy nursing home after his stroke. The doctor selected the rehab and mom didn’t think to check it out. When I say that it was bad, I am not exaggerating. The state actually shut it down. I won’t bore you with all of the details but I commend you for wanting to choose the place where your mother goes.

I chose the place where my mother did rehab and she received excellent care from the staff. There was one incident. No place is going to be perfect. They handled the situation properly so I was satisfied with the overall care that my mom received.

If there are only these three places that are available to you. I am not sure if you can do anything about it.

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