Husband is 68 and there for short term rehab after surgery for abdominal bleeding. He is unhappy there and wants to come home and have home health care instead . We should have done this to begin with but thought the other might be best. A CNA at the facility threatens that Medicare won't pay for time already there if we just leave. Who should I talk to at the facility and does the Dr. that discharged him from the hospital (who is his regular Dr.) need to be involved with getting him out? I know he has to be involved with the home health care. I already have all the meds he takes at home and can get those from our regular Dr. Can the Nursing facility Dr. deny Medicare for this?
Also, typically the doctor following him in the facility will write the discharge order to home and should read something like "discharge to home: include medications, home health: RN, PT, OT, CNA and any other treatments he is receiving. The social worker or discharge planner should then make a referral to the home health agency of your choice (not their choice). You can always leave against medical advice and I have heard but have not experienced (and I have lots of experience at this) that leaving AMA does put your Med A coverage for that stay in jeopardy. Hope this helps...
In addition, within 30 days, if he has a problem, medically or functionally, he should be able to return to the rehab facility if needed under Medicare guidelines. The nurse in the visiting nurse association will be the one to recommend this if needed. Talk with the social worker or discharge planner to get this going. Good luck.