dad needs help- dialysis patient newly diabled amputee diabetic

[u/OkPalpitation8176]

Hi All,

My dad has been battling a number of health challenges.
He was admitted to the hospital for right foot amputation infection which resulted in needing two toes amputated immediately. He was at Kaiser in Northern California. He then needed a heart stent to be strong enough for a leg bypass graft surgery. Which was then followed by removing the remaining toes which occurred in late July.

He was released from the hospital rather abruptly, and has since been in a post acute center. His is a diabetic, with stage four renal failure. He can't currently balance on his own at all, he's not able to use the bathroom on his own and has had few actual physical therapy for this recovery.

The post acute center decided it was time for him to leave this week. My family and I agreed this was ridiculous to even suggest as he is not ready at all to be home. Not to mention our home is not handicap ready yet. The risk was to file an appeal and stay there longer, but then if the appeal should be denied, we would then have to cover the major costs for his extended stay. The decision was made to have him stay with my sister and her husband, an hour away from his hospital, dialysis center, home, BUT its the only option for us now.

I am reaching out for several reasons,

a) Does anyone know what to do about this unrightful release of my dad? Legally speaking?

b) does anyone know of insurance resources that my dad may be eligible for regarding the handicap bathroom remodel, and ramp installation for front porch? Grab bars, handles, special shower, NOT SURE WHAT ELSE ?? Help there would also be GREATLY appreciated.

c) are there insurance coverages for home nurses, diabetic, dialysis equipment for the home with Kaiser Advantage? My parents are retired with this health insurance.

d) anyone have any good tips for helping him for the time being? We are pretty limited at my sisters house. as you can imagine also not handicap/ADA/post foot amputation operation ready.

Sending this out with true hope in my heart for some help. I appreciate any and all attention on this <3

[u/DCRBftw]

Health insurance isn't going to pay for home renovations of any kind. They may cover a rehab bed, wheelchair, etc, but if you need a ramp or a bathroom remodeling, that's going to be 100% on you.

As for the discharge from a hospital or rehab facility, it's usually based on medical necessity and time. If you've been at a rehab facility for X days and you have a certain base level of functionality, you're cleared to go home. They aren't going to pay for patients to be housed places for extended periods of time. And there's no legal recourse because the fine print of the policies states this.

There are situations where in home nurses are approved, but without knowing everything about your specific situation, it's impossible to say whether or not that's an option. You'd have to call Kaiser.

[u/SkyTrees5809 → u/DCRBftw]

He needs to be seen by his primary care MD for overall followup if this is not already scheduled in the next week or two. The primary care doc can order home health PT, OT and nursing. His dialysis center should have a social worker you can also work with to identify needs they can help meet, including home dialysis (which requires training and equipment set up, and he would have to be approved as a candidate I think).Definitely discuss home dialysis with his nephrologist.

Rebuilding Together is a national nonprofit that does home modifications for individuals based on applications that screen for income for eligible homeowners, check their website to see if there is a chapter in your father's area.

Also check with your father's county Area Agency on Aging for more local resources. Living with dialysis and a new mobility impairment is a big transition, and requires a lot of coordination to get his new and ongoing needs met. It's best to keep a notebook and daily notes on phone calls, provider appointments, medications, ancillary services (PT, OT, etc).

His surgeon can order outpatient PT if needed. Medicare will cover assistive devices like a walker or other devices if ordered by a physician.

It will take weeks and maybe months to get thru this transition, so make his needs known to his providers and his dialysis staff as works towards a new normal. Ask him what his main concerns are, and involve him in setting realistic short and long term goals and working with his providers.