My mom had a stroke and needs more rehab at the SNF, but Medicare won't pay

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.

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.

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 Once again if she is unable to co-operate the help will be withdrawn.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.

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.

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.

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.

Talk to the physical therapist about this directly.

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.

Angel

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.

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).

Angel