Father is being forced to discharge from the hospital to home. Can they do that?

Bumping up as I hope others who have been in a similar situation might have some good advice for you.

My immediate thought is that his care sounds difficult for someone to do at home. And that it would not be safe for him to be discharged. Do not go and pick him up, is usually the advice that is given in the situation where family would be unable to provide the care needed.

Your Father is somewhere safe for now. He has a bed but a Rehab ward cannot keep every patient longterm - so it appears you are faced with planning his next bed.

#1 Home is always first choice.
If that is not possible, then #2 home with new or more services. If not possible (not affordable, available, too hard) the next is #3 Care Home (skilled nursing, LTC, Aged Care Residential - names will differ).

Sadly, not every town has a decent care home with a empty bed 😔.

To discuss the *Home* option first..

He currently needs assistance of one person for mobiltiy. Is that right?

Pre-strokes, did he live with someone? If yes, is this person willing & physically able to provide this level of assistance?

'Home with Hope' of more recovery can be done... But hope can sadly turn to plateau & caregivers get overwhelmed & burnt out.

Yeah, No. Nobody can force you to be a caregiver. Do not take him home. If for some reason they send him home, you send him right back. As far as the hospital charging him, let them, I'm assuming if he is on Medi-Cal there is no money to be had anyway. I don't think they can send him out of state either, he would have to be approved for that particular state's Medicaid. Unless California will pay for him to stay there. Be patient, don't accept him home, the hospital will find a rehab center for him eventually.

I don’t live in CA but I’ll share my New England experience. If the hospital is threatening to charge or discharge him say you will file an appeal, and go ahead and file one if you have to. BE THERE when PT comes for the evaluation and document his difficulty walking. (They tried to discharge my mom based on a PT evaluation which concluded she could walk 40 feet, but they never even got her out of bed for the evaluation. She couldn’t walk 15 feet to the BR).

Once dad gets to the rehab your battle is with them. In my experience the rehabs did advocate for as many days as they could get paid by Medicare. The kicker is that when dad is either improved or they deem him unable to improve, the next placement will be on you. It doesn’t have to be at your house (although they will push HARD for that and guilt trip you). But arrangements and payments will fall to you and dad. Sorry. I know how hard this is.

If dad is competent, now would be a good for him time to assign you POA (if you want that). That way you can use dad’s funds to pay for care if he continues to decline.

No, a hospital cannot make an unsafe discharge of a patient to a home where there is no one to safely care for him.
The Social Services of the hospital need to find him placement. If they cannot find SNF then they need to find other placement.

If there is no skilled nursing center that will take him, and no rehab that will accept him there may be reasons for that. He may not fit the requirements for SNF as to be there one often must fulfill requirements that NEED skilled nursing. Same with rehab. If they feel your father cannot be rehabilitated, or if he was recently already in rehab, he may not meet requirements for entry. We can't know details of his own case. You will need to talk to the hospital's social services about just WHY they cannot find placement.

Now we are down to the hospital's threat to send bills. Does your father have great stores of money in savings to pay these bills? Because they cannot collect on his social security, and they can but ruin his credit. Sounds like your dad doesn't NEED credit at this point in his life, so a threat to bill someone who isn't quite wealthy is but a threat. And these bills are HIS, not yours. Never pay them or you are "assuming" the bill and can be collected against or have your credit ruined.

Hospitals do not keep patients who no longer need acute care. That's for certain.
A hospital can also not force FAMILY to assume care they cannot provide.
A hospital can also not collect on bills if a patient hasn't the money to pay them, so that's an empty threat; consider telling them (if this is true) "Dad hasn't any money; go ahead and send him bills; you can't collect on them ever".

A hospital is making empty threats now to your father's family. Tell the hospital that their social services department is responsible for finding your father suitable long term care, and you wish them luck, would be my advice. This is what their social workers are there to do.
Tell this hospital that if it continues to make empty threats to the family they will be reported to JCAHO for unsafe discharge. Use those exact words. JCAHO is the Joint Commission on accreditation of Hospitals. They can loose their licensure for threatening a family in order to get them to take a patient unsafely, and for not using their social services to find LTC placement.

Good luck. I hope you will update us.

Its been said on this forum that MediCal works different than other States that have Medicaid.

Your Dad is on Medical for health? Or in home? Does he have Medicare? My nephew is on for health and I was told that no Dr. can take cash from him if Medicaid is involved. I would call Dads caseworker and run by them what you have been told.

Has Dad been declared 24/7 care? Do the Drs feel Rehab will not help him? Because Rehab means physical therapy and Dad needs to be able to do it.

Maybe the SNFs don't except Medicaid? If they do, they may not take a person with Medicaid Pending. Medicaid for long-term care has to be applied for. If Dad is on "in home care" that may make it an easier transition. Just health coverage does not get you in LTC.

You need to completely understand what your being told. The hospital Social Worker can probably help there. Then call Dads caseworker and run things by them just to make sure u know where Medical stands in this. You make it clear to the SW that to release Dad would be an unsafe discharge. There is no one to care for him. Also, do not pick him up if released, because then you will be responsible for him.

Thank you to this community just had a battle but seems like we’re on a great path now, similar to OP my grandfather has had multiple strokes and needs a walker (that he doesn’t like to use)(April26th) he fell and busted his front left side of the head by his temple, needed stitches and a hospital stay to monitor small brain bleed, then released him too rehab on (May 2nd) during his stay he didn’t want to stay in bed (May 7th) rehab facility called said he’s too combative and they can’t take care of him any more he needs a skilled nursing facility that’ll charge $800 a day or you can pick him up,(not knowing our options) we picked him up as we cannot afford the $800 a day, He was basically acting the same at home trying to do things he hasn’t done in years like cook for himself waking up 1-3AM morning to walk without his walker and try to cook and getting combative when told he’s unsafe to cook or walk without walker. (May 10th) he falls again busted the back left side of his head needed 14 staples this time ER remembered us didn’t even give IV fluids or anything just stapled him up and told us he is fine to leave(he wasn’t), same night gets up without walker falls again, now we start trying to learn options of how to get into SNF was even told by facilities it’s tricky to get him in to one from home that it is usually done from facility to facility, I found this thread and wished we did sooner so we wouldn’t have accepted him back to the home. We started calling facilities building relationships with the people in charge of intake helping us understand the Medi-Cal and Medicare, (May 13th) he woke up confused saying he need to go to work (been retired since 2003) so I took him to ER thinking another stroke this time they admitted him with a UTI causing the confusion and within 2 days they were calling us to bring him home because he can walk more than 50 ft with a walker, I argued and told them No he can’t come home he needs a SNF they argued he didn’t qualify because he can walk with a walker, they threatened us saying insurance will not cover anymore and they charge $5000 a night for every night we are there(he has no assets) so I laughed at their threat and said good luck collecting any of that and to call me back when they can help me get him into a SNF. I’m glad I built a relationship with the intake supervisor at a place near by I told him hospital was being rude and what they were telling me, he called me said let me see what I can do and within 30minutes he called me back saying he pulled some strings with the Dr and will have him at his facility later the same day, and is helping us change our Promed Medicare to traditional Medicare so we can keep my grandfather there for the long term and my grand father makes to much for full scope medi-cal we we have a share of cost which means we pay the facility his entire SSI check and Medi-Cal will pay for the rest.


TLDR: Don’t let the hospital strong arm or guilt trip you into taking your loved ones into an unsafe environment if they need care that you can no longer provide. And build relationships with the intake coordinators they will either help you or point you in the right direction hope this helps you like you helped me, don’t lose hope I almost did but the harder we worked the luckier we got and it all worked out in the end

This does not make sense. My reading about calif SNFs are that for SNFs, there are multiple that take Medi-Cal. SNF needing LTC is supposed to be covered I believe
I would bug the hospital social workers etc about it. If you are not able to have him at home, be firm about that. Tell them that there is no one's home he can go to

Even if someone doesnt need SNF but asssisted living, even some assisted livings take Medi-Cal