My wife is at a rehab facility after having suffered an intracerebral hemorrhage 5 weeks ago. They say she must be transferred to a skilled nursing home. She's 69 years old and in excellent physical shape. I want to take her home. She will be getting skilled care (OT, PT, and speech therapy) at home. Our home is completely set up to care for her. Though we have a basement, our house is a patio home with everything located on the ground floor. We have LTC so it will pay for unskilled care people. So we have both skilled and unskilled care coming in. My wife is barely begining to take steps, can swallow, and needs no medical intervention other than high blood pressure meds and perhaps anti-anxiety pills which I can easily provide for her. I'm the same age - 69 and in excellent health as well.
IF she goes into a nursing home, there's the threat of institutional disease, there's isolation, visiting limited to one person on any given day, there's a good chance of future lock downs with no visitation by loved ones. A nursing home is the last place on Earth my wife would want to be in. Hospitals, rehabs, nursing facilities look like a lost episode of the Twilight Zone with everyone's faces covered up - can't possibly be good for a person recovering from a brain injury.
At home, unlimited social interaction, safety, familiar surroundings, unlimited visitors, she'll get the same amount of OT, PT, and speech therapy and the skilled people won't have to wear masks in our home. Given this, could a rehab facility still force my wife to live in a nursing home against my wishes, with me serving as her medical power of attorney?
I've heard about the threat of Medicare not covering skilled rehab at home if there's a written document from the rehab facility that she needs a nursing home? Is there financial incentive for the medical world to look out for each other and force people to be in institutions to keep the income coming in? Do many people retain an attorney when something like this comes up? In my view there's absolutely no reason my wife should be going to a nursing home. But can a rehab facility say to Medicare that my wife must be institutionalized regardless of how ridiculous it might be? Who can overrule the rehab people?
My husband was in the hospital, with heart problems. They told me he had to go to a skilled nursing facility in order to learn to walk. They had kept him in one position for a week. No wonder he was stiff. I told them that was not going to happen. They started to argue with me, and I stood my ground. He walked in and he was going home. I explained, we were not alone that he was part of a large family in the area and he was NOT going to any skilled nursing facility. The doctor finally said she would have the Physical Therapist reevaluate him. I said OK. After a couple of hours of waiting I went to the nurses station to see when the PT would arrive. I found out they weren't working that day because it was a weekend. By this time I was furious Someone suggested I take him out AMA (Against Medical Advice). I said bring on the paperwork. Before they got it together WALA, here came the discharge papers. I had his niece and a friend meet me at the house, I got out my walker and he got in the house. Within 2 hours he was just fine.
Some people believe that Medicare will not pay if you go out AMA. I called them and that is absolutely not the case. All they care is that they were admitted. How they get out means nothing to them.
My advice is, if you want her home, go get her and bring her home. Hospitals, rehab, skilled nursing facilities are not prison, they cannot keep her against her will.
However, if your wife is terrified of you, could a few weeks in skilled nursing give her some time to come back from the brain injury? I assume this is a new injury related behavior. You can always bring her home from there, too.