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Reply to "Medicare and Rehab stay"
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[quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous]My Dad was at a place that only had private rooms and Medicare covered it....until they didn't.[/quote] OP, this is a good point here and will provide a little more depth: your dad will need to make progress in his therapy in order for his stay to be covered by Medicare. Hospital staff, etc may say, "he has 30 days of rehab therapy covered by Medicare, then Medicare pays for X% after 30 days....," but if he is not making progress in the early weeks, then Medicare will cut him loose and fast. My dad was in a facility where he was able to remain when he "failed" his therapy within a few weeks, maybe just ten days, and we were lucky that there was a "Medicaid" bed available for him at the home, even if he was private pay for some months while applying. Depending on your dad's finances, you may want to take some of those factors into consideration. The hospital discharge staff may be great and help you consider all the factors or they may be overworked and your dad is simply a number on a to-do list and its' "place him wherever you can." Regarding private room, I don't know about Medicare, but when our dad entered hospice-in-place, we were not allowed under Medicaid to pay the difference to have a private room. Good luck to your dad![/quote] This is completely not true. Patients so not have to make progress to continue rehab under Medicare. You should appeal if anyone tells you otherwise. In essence, the Jimmo Settlement Agreement clarifies Medicare’s longstanding policy that coverage of skilled nursing and skilled therapy services in the Skilled Nursing Facility (SNF), Home Health (HH), and Outpatient Therapy (OPT) settings does not turn on the presence or absence of a beneficiary’s potential for improvement, but rather on the beneficiary’s need for skilled care. https://medicareadvocacy.org/jimmo-v-sebelius-factsheet-medicare-skilled-nursing-facility-coverage-does-not-require-improvement/[/quote] My dad was kicked out of Medicare rehab a year before this settlement. So, Medicare covers all LTC charges for someone who enters rehab, doesn't regain some or all of their skills (e.g., walking), and is confined to bed? Medicare covers the duration of their stay, including end of life, even if this for 1, 2, or 3 or more years?[/quote]
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