Skilled-Nursing Facilities: Negotiating the Terrain

Whether or not we plan to, many of us might need to spend time in a rehabilitation facility following an injury, illness, or surgery; knowing patient rights, the right questions to ask, and which staff to seek out can ease the process.

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Be Prepared

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Planning ahead is a great idea if you’re scheduled to have a procedure done in a hospital that requires follow-up rehab. Assistant administrator at a Santa Monica, California rehab facility, Sarah Dereniuk suggests you visit several facilities before your hospitalization to find the best fit. “The hospital discharge planner should provide you with options or your doctor might have a specific recommendation.” Visiting different facilities is the time to ask questions about their operation and services.

Entering rehab is less scary if you know what to expect. Your doctor should explain treatment and therapies that are being ordered before your discharge from the hospital. Dereniuk advises not to expect the nurse-to-patient ratio in a rehab facility that you had in the hospital. “Your nurse probably had you and three others in her care, while rehab nurses may have up to 12 patients. But you should still expect a reasonable response time if you call for assistance.”

Understand Your Insurance Coverage

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Medical insurance is complex, but not understanding your coverage can lead to a big surprise bill later. “Not understanding Medicare benefits has to be the number one cause of confusion for patients and their families when navigating rehab facilities,” says Dereniuk. If you have questions about your coverage for rehab, read over your coverage information or contact your insurance customer service representative.

Know Your Rights

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Upon admission, you’ll be given a list of patient’s rights to review and sign. Your rights include:
• Informed consent – You should be informed about any care you receive, and you have the right to ask questions or even refuse treatment.
• Respect – You have the right to be treated with dignity and respect.
• Freedom from abuse – Your treatment must be free of abuse or neglect.
• Your medical records – You’re entitled to review and get copies of your medical records.

If at any time you feel you aren’t receiving proper care or there’s a problem, ask to speak with a therapist’s supervisor, director of nursing, or the facility administrator.

Designate a Family Advocate

Designate a Family AdvocateMonkey Business/Thinkstock
Rehab personnel are incredibly busy and relaying information about patients’ conditions to family takes time away from caring for patients. Make this easier by designating one family member to be the “communication center,” giving staff notice of who will be contacting them. Healthcare advocate Michelle Katz, MSN, LPN suggests the patient’s nurse is the best person for keeping family updated. “Be sure and introduce yourself to the nurse, and tell her how you would like to communicate and your expectations throughout rehab. Don’t forget to ask about communicating in emergencies or shift changes.”

Patients should always have someone appointed as their power of attorney designee before they enter rehab. Katz says, “Your family members should have a copy with them. This is important if you become incapacitated and need someone to speak for you.”

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Attend Patient Meetings

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Skilled-nursing facilities have regular meetings where staff discusses a patient’s care. Patients and family members are invited to attend. It’s an opportunity to ask questions, express concerns, and hear about treatment progress. Remember as the patient or family member, being in attendance means you’ll be sure to be included in the discussion.

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