How to request rehab after knee replacement?

redcurlsSeptember 19, 2013

I'm having a total knee replacement in a month. Everything I've read seems to indicate that a person who goes to a rehab facility for a week instead of just going home does far better. Apparently they make you go to therapy 3 times a day. I do have a husband who would pamper me if I go home. He has had both knees replaced. He had a therapist come to the house twice a week for the first few weeks, and then he went to a local PT. But he is not as lazy as I am and actually did more than was required. I have Medicare and Blue Cross/Blue Shield which would likely pay. Is it something I can ask for or does the doctor do it? My sister who lives alone in another state did go to a rehab facility for 5 days after hers and did well.

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I had a total knee replacement Sept. 2012. I have the same insurance that you do - Blue Cross/Blue Shield. I went to a rehab facility after my surgery for a week. It was the best think I ever did. I just told the hospital when I made my pre-op surgery arrangements that I was going to this particular facility, and they were actually glad. I went to the rehab facility a few days before the surgery to check it out, then I made the arrangements with them about when I would get there (approximately), and they did all the paperwork and contacted my insurance to make sure it was covered.

    Bookmark   September 20, 2013 at 12:00AM
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Do you have a Rehab facility or a Skilled Nursing Facility (SNF) in your area? The difference is basically the intensity of the therapy. Either of these might be associated with a hospital or with a nursing home type of facility. Maybe even the hospital where you're having the surgery?

You might want to tour any prospective facilities to help with your decision. CARF accreditation is something to look for in a Rehab facility. For SNF be sure it is Medicare licensed. Speak to the person in charge of admissions. If you're having *total* knee you'll probably stay in the hospital 2-4 overnights ("partial" knees stay usually just 1 night). You need 3 overnights to qualify for Medicare SNF.

The surgery hospital will have a discharge planner or case manager that will meet with you & help you figure out the appropriate discharge plan for your situation. It's a good idea to have things in mind ahead of time. Your surgeon or the hospital should have a whole packet of information (pathway) telling you ALL about what to expect & how to prepare.

Hope this helps.

    Bookmark   September 20, 2013 at 12:23AM
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Bee's right. Your hospital or surgeon should give you a packet of info so you know what to expect. You can call and request one now. Additionally my hospital had a mandatory 2 hour class that I had to attend 2 weeks ahead of time. That gave me the opportunity to ask more questions. The hospital social worker also wanted to know if I had stairs at home and how many, if I lived alone or if I had a family member or someone to assist me.

I'm not on Medicare yet so I don't know what they cover and not all private insurance plans will pay for in-patient, hospital based rehab for only one knee. Why not call and ask so that there aren't any surprises after surgery? You'll feel better knowing what to expect.

Last May I had both knees replaced at the same time. I was in the hospital from Monday to Friday and then transferred to a hospital based rehab center near my home for an additional week. Then I had at home PT three times a week for one month and then after that I had 3 months of out patient PT.

My neighbor is having one knee replaced next week. She isn't on Medicare but does have good insurance since her DH is a physician and she'll remain in her hospital for 1 to 2 days post op and then will be discharged home. She'll have in home PT and then out patient PT.

    Bookmark   September 20, 2013 at 6:52AM
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I'd prefer to stay out of institutions and have PT at home.

    Bookmark   September 20, 2013 at 2:03PM
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I would agree with you, Chisue. Less risk of postoperative infections. My DH had knee replacement last june and he went to outpatient PT and also had home exercises per their instructions. He did extremely well in his rehab and recovery.

    Bookmark   September 20, 2013 at 2:20PM
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Your ortho should give the order for rehab. Mine does.

    Bookmark   September 20, 2013 at 3:48PM
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An important thing...start doing PT now two times a day in your own need to get those muscles in shape before surgery.

After my three replacements, I went to the local PT facility 2-3 times a week, but did the exercises twice a day by myself at home also. I tend to stay away from the hospital/nursing home settings.

Good go get on your bed and get those leg lifts started!

    Bookmark   September 20, 2013 at 5:01PM
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I had a total hip replacement in July and did go to a rehab facility, which was great, The hospital social worker asked me for my 1st, 2nd, and 3rd choice. Then its up to which one has room at the time of discharge. What I did beforehand was check out a few of the nearby places I was considering. Two friends had done rehab at one of them right in the neighborhood and highly recommended it. It made me claustrophobic.

My surgery was scheduled quickly, so I didn't make formal appointments, just kind of popped in when I could (usually late afternoon, not a busy time for them) just to get a feel for what they were like. They were all good enough to give me a short tour... the rooms for short term rehab, the exercise room, and I asked about meals--where do we eat, the type of menu. I did fill in an application for "the one" I really wanted, and when the SW contacted them, they had a room so I got my 1st choice.

I also have Medicare and BCBS. There was a $50/day copay for rehab that Medicare doesn't cover. Came as a surprise, but the place was sooo worth that and more. Doesn't seem to matter if you pick the most or least expensive, the copay is the same. And there is really very little price difference between them!

The visiting nurse and PT come to your house when you go home, whether its right from the hospital or do rehab first. You'll do fine.

    Bookmark   September 20, 2013 at 11:19PM
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I had a total left knee replacement last Oct. After the hospital I went to the skilled nursing facily across the street for another 5 days, they wanted to make sure I could take care of myself since my husband has his own health problems and couldn't help much. The day after I got home the PT started coming over, everyday for over a week, maybe 2, I don't remember, but they came to the house, I didn't go to any facility for therapy. Occupational therapy came a few times, nurses every few days.

    Bookmark   September 20, 2013 at 11:34PM
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