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My dad was seen at a local "Doc in the Box" for a bladder infection on Friday 2/3, because we could not get in to see his regular doctor. The director of the assisted living center where he lives asked that I take him to the doctor, saying he was disoriented and not eating, which showed signs of possibly being a urinary tract infection. The doctor there prescribed Bactrim, which really did a number on him. It took his appetite, and he continued to be somewhat disoriented for several days afterward.
On Tuesday morning 2/7, he suffered a fall at the assisted living facility, which required him to be seen at the local ER. He was deemed to be okay and I took him back to the facility after about 4 hours. The next day, on Wednesday 2/8, he had to be transported back to the hospital, this time with continued disorientation and loss of appetite. He was admitted to hospital that day with a diagnosis of acute renal failure, later deemed to be the result of the Bactrim, which can harm the kidneys. He remained hospitalized until Tuesday 2/14, when he was discharged to a local rehabilitation facility for physical therapy.
On the night of 2/16, he was once again transported back to the ER, this time with difficulty breathing. Tests showed a pocket of fluid (possibly blood) that was positioned just above his right lung, putting pressure on that lung and making it difficult to breathe. This could possibly have been a result of the fall he suffered back on 2/7. He was subsequently admitted and immediately transferred to the MICU unit. The next day after being admitted (2/17), a thoracic surgeon performed a procedure which drained that pocket of fluid/blood from his chest cavity. He remained in MICU until 2/25, at which time his chest tube was removed and he was moved to a general medicine room. He remained in the hospital until 2/28, when he was discharged back to the rehab center.
This morning (3/9), I had a meeting with the staff at the rehab center, and they informed me that he was not going to be a viable candidate to return to the assisted living facility. They are counting him as having been a patient at the rehab facility since 2/14, when he was hospitalized for 12 of those days. Is it legal for the rehab facility to bill Medicare for 12 days of rehab for a patient who was in the hospital, not receiving therapy, especially when he was in the MICU unit? Medicare is supposed to pay for 20 days of rehab, but he’s only had 12 days maximum (2 days prior to the next hospital stay and 10 days following, not counting weekend days, when no therapy is even done). Something sounds fishy to me here.

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I'm assuming that the rehab bed was held while he was in the hospital, yes? So they need to be paid for it. Similarly, weekends count even though there is no therapy given. The payment is for room/board/nursing coverage/medication administration and all the other services given, with therapy during the week.

If you want to make certain that this is the case, contact Medicare. Can you google to get an 800 number for them?
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We did not know that they were going to count time in the hospital as time for which they would bill Medicare. He's been back in the rehab unit for 9 days, and has had only 7 days of therapy since then (therapy is not offered on weekends). Following his first admit to the rehab facility, he had just one day of therapy. That's a total of 8 days, and they told me he has 9 days left...problem is, they are counting weekend days when no therapy happens. That's the next 2 weekends. So, we effectively have just 6 days of therapy remaining. They told me yesterday that his Medicare time "was up." That will come to a total of 14 days of therapy, when Medicare pays for 20.
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Didn't you query it when they told you they were planning to do this?

If it were me I'd call Medicare and ask them. Yes, at first sight it seems an absurdity for them to allow his rehab allowance to run continuously when after only two days he was back in hospital, and stuck in hospital for a fortnight; but maybe there is some convention about it. Call them and see.
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