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By Shawn Barnes

You successfully navigate numerous hospital elevators and then unfazed, you traverse the maze of hallways to finally find your loved one’s room.  You pause at the door; images of tubes crisscrossing your loved one’s veins hang like spider webs in your mind, memories of visits past and crises averted.  Will this be the same?  

You knock and slightly open the door. Your loved one’s breathing sounds weak against the hum of machines. You enter to find them alone in the room, sleeping in the low light from above the hospital bed. Now, together with your loved one for the first time, you feel alone. Everything happened so fast.

You admit you don’t know what to do or where to begin. You realize that you don’t know what you don’t know, as they say. What do you do next?

Follow these tips.

1.Find the Nurses’ Station. Ask if your loved one has been “Admitted”, or is being held “Under Observation”? This is important. Your loved one will have “the right” to recover in an inpatient rehab only if your loved one has been Admitted to the hospital for three midnights, or more.  If your loved one is being held Under Observation, no “right” to rehab exists. Being held Under Observation will affect your planning as it means your loved one will discharge home. If not Admitted, you may ask to speak to the attending physician about moving your loved one to Admitted status, given their history and your experience with them. After all, the answer is no if you don’t ask.  


2. Find the Social Worker, or Nurse Case Manager. You can usually find the Social Worker in an office tucked behind the Nurses’ Station. They work during business hours. The Social Worker reports to the Nurse Case Manager, who makes the discharge plan. Ask the plan for your loved one.


3. If your loved one has been Admitted, and remains in the hospital for three midnights, then the Social Worker/Nurse Case Manager will recommend Inpatient Rehab. They will present you with a list of Skilled Nursing Rehabilitation Facilities, aka nursing homes.  Do some research. Begin by going to www.Medicare .gov.  Scroll to the bottom of the page. Under “Take Action”, click on “Find Care Providers.” Scroll down to “Nursing Homes”, click and then input your address on the next page. Medicare rates nursing homes using a star system, 5 Stars being best. You can scroll through each listing to find their outcomes with specific conditions/diseases/therapies. Have a plan. Then, you can better decide and make a selection from the list. You will see the Nurse Case Manager/Social Worker again the day before or the day that you are discharged. Then, it will be too late and your loved one will discharge to the first community that accepts the hospital referral.


4. If your loved one discharges home immediately because they are not Admitted or do not “Qualify” for rehab, consider In-home care. Sometimes confused with “Home Health” which is a service of Medicare and private insurance that pays up to 60- days of home-based nursing and therapy.  But, not bathing, cooking, transferring, toileting, dressing, or any other “Activity of Daily Living (ADL)”. For help with ADL tasks, your loved one may need In-home care.  For more information, contact CarePatrol at www.carepatrol.com.


5. If your loved one discharges to inpatient rehab, the insurance will pay up to 20 days, as long as your loved one completes therapy, improves, does not plateau nor digress. Your loved one may receive another 80 days of rehab with a copay, roughly $185/day.  


6. Plan for what you will do when your loved one discharges from rehab, and where they will discharge. If home is appropriate, make sure to prep the home by removing tripping hazards like extension cords or throw rugs, and discarding old food. Help to make your loved one’s home environment as safe as possible, as if it were an Assisted Living facility.


7. If needing Assisted Living, consider a placement professional, like CarePatrol, www.carepatrol.com