No!!! Tell them she can’t come home with you and needs to be discharged to a rehab. |
Medicare pays for rehab if doctor orders it. But they pay in increments, as long as patient is improving--generally up to max 90 days.
If/when patient stops improving then the waters get murky. Medicare no longer will pay, however nursing home can't discharge a patient who doesn't have a place to go that can care for the patient. If this is the case, then they keep the patient and it becomes private pay. If patient has no money, then social worker or family member gets approval for MediCAID and rehab facility accepts that or patient must find a MediCAID bed. Once someone is in a rehab facility things can get tricky money-wise. |
This is not accurate. There is no medical improvement standard in Medicare. See Jimmo vs. Sebelius. |
PP is right about needing to continue to progress to get Medicare payment. There is also discharge criteria so that once a patient reaches a certain point Medicare will no longer pay. Rehab is available in rehab hospitals and subacute facilities (nursing homes). To be eligible for a hospital based rehab, the patient has to be able to tolerate three hours of therapy a day. Some subacutes have assisted living as well which can be beneficial if a resident isn’t capable of living alone but doesn’t need a nursing home. Just throwing out some additional things to think about and research. |
DP. You always post this. Yes in circumstances where rehab is necessary to prevent deterioration Medicare will pay. It isn’t likely that OP’s mom will find herself in this situation. But if she does there is still a lifetime maximum days of Medicare payment. And after sixty days there is a coinsurance. After 90 days you get to pay 100% of the Medicare daily rate. And after 150 days you get to pay 100% of the facilities actual charges. OP’s mother might have other insurance that will change this. But point is, Medicare is a short term limited benefit. And Medicare doesn’t pay in cases where there is no progress and no risk of deterioration without professional services. And, in most cases, it makes no sense to exhaust lifetime days unless you are at the end of life. |
Update: my mom is still in the hospital and at this point the doctors give her a 50/50 chance of surviving. This is not the outcome I expected at all. She was healthy a week ago. Hug your elderly folks this holiday.
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I am so sorry OP. |
I found this happened in general as my parents got older and were in and out of the hospital. It's the worst. |
I’m so sorry, OP. 💔 Holding you and your mother in the light |
Hugs OP. Love. |
I’m so sad to hear this update. Lean on this group if you need some support, everyone on here was a tremendous help to me last year when my mom was going through an incredibly rough time. We are here for you. |
I am so sorry. I know the strokes were a shock and now the prognosis. Just so sorry and holding you and your Mom in the light.. |
Same for me-people here were so helpful and kind. I'm sorry OP. It's hard when things happen so fast. Not giving false hope, but sometimes the elderly can rally back-even my dad rallied a few times. Best wishes to her and you. |
Thinking of you today OP, and hoping it is a better day for your mom. |
So sorry op, but sometimes it’s for the best. Sounds like a truly terrible Christmas. |