When a loved one is hospitalized, it’s natural to feel overwhelmed and have a host of questions about their care, your role in decision-making, and how best to support their recovery. Understanding your rights and options, particularly when it comes to post-hospital rehabilitation, can help you make informed choices that align with your loved one’s best interests. Here’s what you need to know.
What Should I Ask My Social Service Professional?
Hospitals often have a team of social service professionals or case managers to help patients and families navigate care options. When speaking with them, you might ask:
– What are our options for rehabilitation and other aftercare services? This includes inquiring about specific facilities, at-home care, or other support options.
– What kind of financial assistance is available? Social service professionals can often guide you in understanding insurance coverage, out-of-pocket costs, and available financial resources.
– How does the hospital coordinate with rehab facilities? Knowing if they work closely with certain centers or if you have the freedom to choose can impact your decision.
– What support is available if my loved one is discharged home alone? They can help coordinate resources like visiting nurse services, physical therapy, and other in-home support.
– Who is responsible for ensuring continuity of care? You’ll want to know how the transition from hospital to rehab or home is managed and whom to contact with questions.
Do I Have the Right to Make Decisions for My Loved One?
As a spouse, child, or designated caregiver, you generally have the right to make decisions if your loved one is unable to do so, but this depends on several factors:
Does your loved one have a Health Care Power of Attorney (POA)? If your loved one has designated you as their health care POA, you have legal authority to make medical decisions on their behalf. In many cases, states allow family members (spouse, adult children, or parents) to make decisions if no advance directive is in place. However, having legal documentation in advance is best. Patients have a right to choose their care providers, including rehab facilities, if they’re capable of making those decisions. If not, a designated representative generally makes decisions in their best interest.
Can I Choose the Rehab Facility?
Yes, you have the right to express your preferred rehab facility or type of care, but it is subject to some limitations:
Insurance Coverage: Some insurance plans, including Medicare, may limit facility options or cover specific centers only. Always verify with the social service team and your insurance provider.
Facility Availability: Some facilities have waiting lists, so it may be beneficial to have a few options in mind.
Rehabilitation Needs: The type of rehabilitation (e.g., physical therapy, occupational therapy) your loved one needs may determine which facilities can provide adequate care.
Your loved one’s preferences, needs, and overall health will guide the selection process. If possible, visiting the facility, speaking with staff, and reviewing the rehab center’s reputation can provide assurance that they’ll receive quality care.
Carl lived alone but had the loving support of his family, who lived an hour away. He was facing a knee replacement so he could continue his love of golf and puttering around the house. He decided to plan ahead for his recovery after surgery. When his family visited, they toured several Rehabilitation Centers and Retirement Communities that provided Skilled Care and rehab. He was able to make the decision and complete the proper paperwork to come to McCrite Plaza after the day of his surgery. He completed his recovery and was able to move back home. He made several good friends during his stay and continued to visit McCrite and was always happy to reengage with friends and staff.”
Planning in Advance of an Emergency
To ensure your loved one’s wishes are respected, take proactive steps:
Talk with your loved one about their medical preferences. Create a living will or a health care power of attorney to formally outline their choices. Review what Medicare, Medicaid, or private insurance covers regarding rehab and long-term care options.
Research and list rehabilitation centers, assisted living, or in-home care services that meet your loved one’s needs. Knowing these options in advance can make the transition smoother in a medical emergency.
Create a plan for staying in touch with medical and social service professionals and a system for accessing your loved one’s medical records.
Who Pays for Rehab, and What Out-of-Pocket Costs Should We Expect?
Health insurance typically covers rehabilitation costs, but out-of-pocket expenses can still be significant.
- Medicare usually covers inpatient rehab in a skilled nursing facility after a qualifying hospital stay (three or more days). However, there may be a co-payment after a certain number of days. Outpatient rehab and home health services may also be covered under Medicare Part B, but deductibles and co-pays may apply.
- Medicaid often covers rehabilitation for qualifying individuals, especially in approved facilities, but eligibility and coverage details vary by state.
- Coverage varies, but most plans cover rehabilitation to some extent. Confirm your benefits with your insurer and ask about co-pays, deductibles, and caps on covered days.
- Patients and families may face out-of-pocket expenses for certain therapies, services, or facility fees. Co-payments for rehab can vary widely, especially in skilled nursing facilities where daily rates often exceed insurance coverage.
Be sure to clarify the financial obligations with the hospital’s social service team, the rehabilitation facility, and your insurance provider. Knowing what to expect financially can prevent surprises and help you plan accordingly.
The Goal of Rehab After a Hospital Stay
The primary goal of rehab following hospitalization is to help your loved one regain independence, manage pain, and improve mobility or cognitive function. Rehabilitation may also focus on specific health needs, such as:
Strengthening after surgery is especially common after joint replacements or cardiac surgery.
Recovering from a stroke or neurological condition requires targeted therapy to improve motor skills, speech, and cognitive abilities.
Managing chronic conditions includes therapy to help with conditions like arthritis or pulmonary disease to reduce symptom severity and enhance quality of life.
What If My Loved One Lives Alone and Has No In-Home Support?
If your loved one lives alone and cannot return home independently, several options can provide the support they need:
Depending on their condition, they may be eligible for an extended stay in a skilled nursing facility or rehab center until they can manage more independently. Services such as visiting nurses, physical therapists, and aides can support daily activities and rehabilitation exercises. Personal Emergency Response System (PERS) allows your loved one to summon help if needed, providing additional security if they return home alone.
Assisted Living or Short Stay Care is an option. If returning home is not viable, Assisted Living or a Short Stay may offer a temporary or permanent solution. Social service professionals can help explore these options.
When navigating a hospital stay and rehabilitation plan, remember that both patients and families have rights. You are entitled to participate in care decisions, ask questions, and advocate for services that prioritize your loved one’s needs. Taking proactive steps to understand your options, prepare financially, and involve social service professionals ensures you make the best choices for your loved one’s health and recovery.
Come for a tour at McCrite Plaza to fully understand all the options provided. It is always best to do due diligence beforehand so that in case of an emergency, you are well prepared to tell hospital staff what community you’ve chosen.
Call McCrite Plaza in Briarcliff-Kansas City at (816) 888-7930 or (785) 267-2960 in Topeka to schedule a tour, or complete the contact form below.
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