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Thread: Delay in rehab?

  1. #11
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    My father is not a Vet unfortunately.

    His current health insurance is a Medicare replacement plan with no max on rehab length. So he doesn't have straight Medicare since it's a replacement plan (not supplement). It's not a common plan he has, but luckily rehab length isn't maxed like Medicare is. It is a replacement plan from United Healthcare.

  2. #12
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    Thank you 2drwhofans for your insight.

  3. #13
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    UPDATE!! Hospital is saying my dad needs to be out ASAP and they can't delay discharge anymore. I have called every contact we have at Shepherd (left all a voicemail), I have called his case manager at current hospital (left voicemail), and spoken to patient care advocate (she's looking into this). Any other suggestions and ideas on delaying discharge? My father needs to stay at current hospital until Shepherd can admit him on 1/30. We plan to do Medicare Discharge appeal too.

  4. #14
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    Just so you have more options, you might want to take a look at Brooks Rehab in Jacksonville. They have an excellent SCI program and the Neuro Recovery Center, which provides continued access to rehab equipment, facilities, and therapists post acute rehab for $100/month.

  5. #15
    Quote Originally Posted by KellyA View Post
    UPDATE!! Hospital is saying my dad needs to be out ASAP and they can't delay discharge anymore. I have called every contact we have at Shepherd (left all a voicemail), I have called his case manager at current hospital (left voicemail), and spoken to patient care advocate (she's looking into this). Any other suggestions and ideas on delaying discharge? My father needs to stay at current hospital until Shepherd can admit him on 1/30. We plan to do Medicare Discharge appeal too.

    Nothing has changed. You can still say no. They are just trying to scare you. It's Monday, so they push the most on Mondays.

    Just be firm, but polite.

    Look at our prior advice.

    Call Shephard twice a day. Be nice, but be eager.

    Keep calling your advocates, as you are.

    Only call Medicare at the last minute.

    Does he have any active medical issues right now? Infections. pressure sores, unstable vital signs, blood clots? All reasons the hospital can still bill the insurance company for care in the interim.

    Threaten to get a lawyer involved, if you want. They are risking the health and long term survival and recovery of your father by pushing for early discharge to a suboptimal facility. But there's no need to hire a lawyer. But you can threaten.

  6. #16
    Is this the same person or someone else??

    http://sci.rutgers.edu/forum/showthr...ened-discharge!

    (KLD)

  7. #17
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    Looks like that's my sister. She must have posted too. At this point we have it smoothed out. His current hospital has agreed to keep him until Shepherd can admit him on Friday now (yay!). Thanks all for support. Patient Care Advocate was able to help.

  8. #18
    Quote Originally Posted by KellyA View Post
    Looks like that's my sister. She must have posted too. At this point we have it smoothed out. His current hospital has agreed to keep him until Shepherd can admit him on Friday now (yay!). Thanks all for support. Patient Care Advocate was able to help.
    Good for you and your sister !
    We have to fight for our loved ones.
    Hope your Dad does well at Shepherd,

  9. #19
    Hi, My mom is in a similar situation at a hospital in St. Pete, Florida. She was turned down by Shepherd. The hospital desperately wants to dc her to SNF such as Kindred and bamboozled my dad into signing consent to refer her there. I politely told the social/case worker that I am aware that an interruption in care would make it impossible for my mom to go to rehab and that she would not be going to a SNF. I contacted Brooks and we should know soon if she will be accepted. She has private insurance and no medicare or Medicaid. Since they so desperately want my mom out of their hospital, can they do that even with private insurance? I'll just refuse and tell them to bill me I guess.

  10. #20
    Quote Originally Posted by RACH555 View Post
    Hi, My mom is in a similar situation at a hospital in St. Pete, Florida. She was turned down by Shepherd. The hospital desperately wants to dc her to SNF such as Kindred and bamboozled my dad into signing consent to refer her there. I politely told the social/case worker that I am aware that an interruption in care would make it impossible for my mom to go to rehab and that she would not be going to a SNF. I contacted Brooks and we should know soon if she will be accepted. She has private insurance and no medicare or Medicaid. Since they so desperately want my mom out of their hospital, can they do that even with private insurance? I'll just refuse and tell them to bill me I guess.

    You can always protest and appeal a hospital discharge with the patient advocate.

    Kindred hospitals are not, to the best of my knowledge, SNF's. They are Transitional Care, AKA "Long Term Acute Care" facilities
    ( LTAC ). LTAC's are for persons needing extended inpatient care for an active medical condition. The condition was to have been stabilized in the acute hospital and then longer term care for this acute condition occurs in the LTAC. LTAC patients are usually admitted under the care of a internal medicine specialist or hospitalist. The admitting doctor calls in specialists including PT/OT and Rehab Doctors.

    The decision about her not initially qualifying for acute rehab may have to do with several things:

    1. Her having a medical condition that still needs acute care.
    2. Her not meeting the "three-hour" rule for inpatient acute rehab facilities. Three hours of combined therapy including P.T, O.T. and /or Speech Therapy.

    Commercial insurance companies often publish their criteria for rehabilitation levels of care online. You can also call the customer service number on the back of her card and have your Mom give them permission to let you talk to their case manager about the criteria.
    Last edited by 2drwhofans; 04-25-2017 at 10:48 AM.

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