Why would a rehab facility want to discharge someone who has 100 days paid care, after 30 days, when care is unsafe and health risks apply?

Who signed the discharge paperwork? Your grandmother? Was another family member present?

In the future, the family should probably make sure that another family member is present to review the paperwork and look out for omissions like the one that occured here.

My dad has supplemental insurance to cover additional cost after 20 days. After 40-plus days, he started refusing PT and OT so he went on self-pay where he remains today. Because of recurring cellulitus and 2-person transfer, he was refused at 2 different memory care facilities and I have been unable to find a personal care home to take him. So this is where he remains today at a cost of $11,000 per month.

100 days is not a guarantee and Medicare does not pay for it fully. Only the first 20days is paid 100%. 21 to 100 is 50% with the patient paying the other 50% or their suppliment partially or fully pays the balance. This should have been discussed by admitting when Grandmom was admitted. They can actually tell you what portion you will pay, for my Mom it was $150 a day.

Medicare determines when the person is discharged. If from reading the therapists notes they feel the person will not improve they recommend discharge. Your family could have appealed the findings claiming it was an unsafe discharge.

Rehab facilities are there to do rehab work. They are heavy on PT and OT people, and their mission is to get the patient to work regaining all they can so as to be able to be discharged more able to do the ADLs, or Activities of Daily Living. No, the bed gets about what medicare pays. But they must keep meticulous records by all entities, PT, OT, Social Workers to demonstrate that the patient is making progress. When the patient can no longer make progress, or isn't working, or is choosing not to participate, or cannot get any better in their professional opinion then discharge time is there. The Social Worker will now work with family to either accept the patient back in home care, or to find placement if family can no longer care for them. Rehab care is quite expensive and is your tax money at work; they have to prove their care is needed.

Your grandmother probably reached her therapy goals at the SNF thus why she was sent home.
Rehab beds usually have a fast turnover rate. Your GM suffered a fall and was getting better. We don’t know her baseline prior to the fall.
If there were concerns I am wondering why no one from the family spoke to the SNF staff prior to DC. A nurse usually reviews the DC instructions with the patient and family. The patient signs the DC orders prior to leaving the SNF as well.