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My 90-year-old mother broke her lower thigh bone about 20 days ago. She was hospitalized for almost two weeks and was sent to an SNF for what I thought would be 20 days fully covered by Medicare.


A social worker called today to let us know Medicare would cover only 7 days. She gave me a number to lodge an appeal which I did.


Is this a new policy?


My mother still needs help. She cannot stand on her own & cannot sit in a chair. She needs a catheter and a nurse to feed her meals.

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You are not guaranteed 20 days of Rehab because Medicare will pay for it. Medicare determines how long Mom stays. You need to find out why Medicare feels she only needs 7 days of Rehab for a broken bone.

Your Mom is in rehab for only the broken bone. Was not being able to stand on her own and not being able to sit in a chair prior to her hospitalization? If so, Medicare does not pay for prior problems. Needing a catheter and needing feeding is not a Rehab thing unless its to teach the person how to do it for themselves. Again, if these were prior problems, not part of this Rehab. Maybe Mom is not rehabitable. She is 90 and sometimes something Iike a broken bone and a hospital stay causes further decline.

If her not being able to stand and sit in a chair are from breaking a bone, then I would ask the therapist why only 7 days. I am surprised that they are not trying to keep her the full 20 days Medicare pays % for. You may also need to consider with Moms problems if you want to continuing caring for her. If not, this is where u have her transferred directly to Long-term care. Using what money she has for her care. If no money, you apply for Medicaid.
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She may be a candidate for LTC, which is covered by Medicaid (if she qualifies) plus her SS. A doctor needs to assess her to need LTC.
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You are right with the long term care plan. However, if she is entitled to 13 more days of Medicare paid care in a SNF she should receive it.

She hasn't been there the full 20 days yet.
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Look at this big picture....Even if she gets 3 weeks it looks like she might not be fully recovered. After 21 days she can stay at around $180 per day or whatever this years rate is up to 100 days. She needs to make progress within the first 3 weeks. Someone is feeding her. That does not appear well. What is her prognosis of where she will be next month. What are your plans? Can you take care of her at home in her condition? It seems unsafe to discharge her.
Ask for a care meeting to determine her goals. It sounds like she will need long term care and you may need to plan on this. Does she qualify for Medicaid? The social worker can help with this.
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