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Medicare will only pay for 100 days of care in rehab, and during those 100 days the patient must be making progress. Once the doctor decides the patient is not making progress, the coverage ends.
What was the reason for the ending of coverage? Did they say she wasn't making progress any more? If so, that is the reason.
There comes a point where the doctors decide that a patient simply won't benefit from more rehab. This can happen if the injury is too severe, or if the patient will not comply with rehab (refuses to do the required work).
upsetdaughter, she may need aides or a visiting nurse at home. Be sure you talk to the discharge coordinator about what help she can get at home with you, including an adjustable bed, commode, walker etc.
You can usually get the therapists to teach you how to work on things, and possibly you can get some in-home therapy as well. Sorry this is happening. My mom hated it when her therapy stopped but could not grasp that she had to actually participate more actively to keep it going.
My mom has dementia. She broke her ankle. After hospitalized the Dr.said for her to go to a snf. She has been there45 days. She is still in a cast and the Dr said she still needs rehab and cast for 4 more weeks. This Dr visit was two days ago. Today the snf called a meeting. They said she is not making progress and Medicare will not pay any longer. I will have to take her tomorrow. They said one of her goals was to do wheel chair transfer from bed. She is 87 and has a cast from her knee to over her foot. Said she can't remember the exercises from one day to the next. She has dementia. They said she was very sweet.
Mom may have PT prescribed at home along with some nursing care. One of the best solutions is to have the PT instruct the caregiver on how to assist the patient. She clealy can't remember how to do the exercises herself. Once again if she is unable to co-operate the help will be withdrawn. Each visit has to be documented so progress will be noted and determination of eligibility will be made. I would also keep my own diary of Mom's daily activity.
They have a point system that they use to establish her progress and said that Medicare would only approve 14 days. She is making good progress from being bed ridden to getting into a wheelchair and bake a cake, but is not able to walk with the assistance with a walker yet. She is close to getting there, but the Case worker won't approve Medicare. I understand that Part A pays for up to 20 days then copay for day 21 to day 100.
I wonder what they have decided that the goal of the rehab is. For example, was the goal to get her walking again? Or was the goal just to get her to ambulate a few steps to do a wheelchair transfer. Is it in her file somewhere that walking is no longer possible? If this is the case, then the rehab is considered done by the facility.
I would have a meeting with the head of nursing about what the goal is for her rehab.
Upset, please go to the home page, go down to the " experts box" and read the article about Getting Medicare to pay for SKILLED Nursing Care. They are most likely incorrect about the improvement thibg. Medicare has changed.
These situations where patients are in a cast seem particularly troublesome; she's going to need PT AFTER the cast comes off.
I believe the article about the changes in Medicare regulations would apply to this situation; it sounds as though this lady need to be in SNF until the case comes off the then will need more intense PT to get her walking again.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
What was the reason for the ending of coverage? Did they say she wasn't making progress any more? If so, that is the reason.
There comes a point where the doctors decide that a patient simply won't benefit from more rehab. This can happen if the injury is too severe, or if the patient will not comply with rehab (refuses to do the required work).
Angel
I would have a meeting with the head of nursing about what the goal is for her rehab.
Angel
I believe the article about the changes in Medicare regulations would apply to this situation; it sounds as though this lady need to be in SNF until the case comes off the then will need more intense PT to get her walking again.