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You are so correct Barb, and the hospital "stay: can be sneaky as well. You have to make sure you hear the words that your loved one is admitted. I have heard horror stories of people being in the hospital for days, but kept in "observation" status, which leads to nightmares as far as to what insurance covers and doesn't. I learned to ask early on "my mom is being admitted, right?" and once I was told yes, I took down the name of the medical person who told me that, just in case.
And the person must be participating fully in the rehab program. They must be able and willing to do everything they are asked in terms of exercises, etc unless there is a very, very good reason why they cannot do so. I observed a rehab lady request that the therapist come back tomorrow because she was "too tired" for therapy that particular day. She then requested assistance from the staff to change into a hospital gown and be put to bed. She acted like it was a vacation and she was calling the shots. Not so. Rehab is serious stuff. I'm sure that entire situation was documented and Medicare reviewed it. Whether the lady intended it to be the case, she technically refused therapy - which is the entire reason for being in rehab! She was discharged WELL before the max number of days, so be prepared for that as well. I think the woman may have thought she had months in the rehab and that may have contributed to her "come back tomorrow" attitude. Please remember that Medicare can discharge her with little notice and there's not a lot you can do about it. An appeal will get a short amount of additional time (like 2-3 days).
Yes, and as explained. And that out of pocket mounts up if there the whole 100 days. A good financial officer will explain how it all works. TG Moms first stay in rehab I had a very good person. Second stay, I was home before I realized nothing was explained to me. Do not sign anything making you responsible for the bill unless ur the one getting the care.
Rehab does not cure. Their job is to try and get the person back to be as independent as possible. Sometimes that doesn't happen. A person will plateau. In the elderly an illness and a hospital stay can take a lot out of someone. Sometimes they never get back to who they were before the illness. Medicare determines when the person is discharged from the reports they receive.
Yes, it's true and it can be a nightmare if your lo is non compliant with therapy. You will get charged for every day after the 20th day. I don't know but it seems so unfair because each person is different and some get going quicker than others. My Mom got a bill from her rehab/assisted living for her extra days stay. They really think people are going to bounce back from broken bones and be up and about after a few ROM exercises. I also think they want the family members to be responsible for the rest of their so-called rehab. Ha.
Rehab still collects from Medicare after Day 20, what Rehab sends you is called CoInsurance, which can quickly add up, especially if there is no supplemental insurance to cover the cost.
Momheal, not when rehab is involved. That 80% is for regular medical bills. Hospital stays, doctors. Medicare pays 80% of what they feel is reasonable. The 20% is paid by the patient or their secondary insurance. And not all insurances pay that 20%. My Moms Medigap and my DH union BC/BS only paid half of the 20% Mom and I pay the other half. Its called a share fee.
Medicare pays 100% the first 20 days, 50% the 21st to the 100th day. The other 50% is paid by the patient or if lucky the secondary picks it up fully or partially. Its been 5 yrs but my Mom paid $150 a day for the time she was in over the 20 days. That mounts up.
As Mysteryshopper says you can be released for non-compliance. You have 3x you are allowed to turn down therapy.
They may cover longer if there is a crucial NEED to cover longer. They did in the instance of my brother because while in 21 days he had made all of the progress he was likely to make in OT and PT he did have some further wound care needs that " bought him more time". There has to be very good reason for an extension for medicare to cover it. That is up to the documentation of the doctors and nurses at the rehab.
From your profile: "Her skin disease has since cleared up and we are trying to get her released, how do we legally get her released? She wants to come home and we have family that lives with her and takes care of her..."
Who is making her stay? Why are they making her stay? Or has it just not been discussed with her? If she's competent, she can request discharge. If she's not competent, her medical POA can request discharge.
You indicate she's been there a month and her issue has cleared up. Since that's over 20 days, there will be a bill. I would be rattling the admin cages to find out why they still have her there.
I thought it was Medicare paid 100% the first 20 days and then you or you secondary insurance pay 20% and Medicare pays 80% thereafter up to 100 days? I think I lucked out with moms secondary being an amazing plan that does not even exist anymore. I do remember the hospital stay had to be “admitted” and not “observation” for 3 full nights in order to qualify for rehab.
Just read disgusted's reply. I would question the need for her to still be there. If she has been there a month, then she probably owes at the least 1500.
Just read your profile. Talk to the Director of Nursing and request that she be discharged. That there are people who live with her who can handle any care she needs. In home can be set up to check on the rash. She will be seeing her PCP. And if money is a problem, tell her that. Even if not, I would tell them she does not have the money to stay any longer. No, you do not want to apply for Medicaid. She wants to go home.
Rehabs are not prisons. But, they can't make an unsafe discharge. So comply to anything they suggest. We had one poster where all they had to do was prove they set up an aide. I told them to set up the aide, when LO got home then cancel it. There are no Rehab police. But they are a business. And they will milk Medicare and insurance as long as they can.
You may not want to go Against Medical Advice because they do not have to send you home with any prescriptions or set you up with in home care. But you can go AMA and just see her primary ASAP. He/she can set her up with what she may need.
You have me curious now so please update us on how this goes. Oh, if they still won't release her callyour State Ombudsman.
I believe that traditional Medicare will cover medically needed./authorized rehab fully for the first 20 days in a benefit period. If the rehab is needed after day 20, Medicare will cover 80% of the cost and the patient (or hopefully their supplementary insurance) will cover the remaining 20%. This is all providing the patient is able and willing to participate in rehab. A person who can't or will not participate can be discharged from rehab. If the patient has no other skilled nursing needs, Medicare will inform the facility that they will no longer pay anything for the patient. At that time, the discharge social worker will have to arrange for a safe discharge. If no "safe" discharge can be arranged, the patient will have to apply to Medicaid which is the only insurance (outside of private long term ins) that will pay for long term care. Each state administers Medicaid slightly differently so you would need to check with the Medicaid Dept of the state in which the patient resides. In any event.... most states will do an interview regarding a financial "look back" of 2-5 years and a spend down of assets to about $2000.00. You would also need to supply major life documents such as birth certificates, marriage licenses, divorce papers, enlistment/discharge papers (veterans may be entitled so specific benefits and should check this with the VA), property deeds and mortgages, utility bills, bank statements, receipts for large purchases, etc.
Medicare Advantage programs have very different guidelines and you will need to carefully read their contract to see their monetary and time limitations.
If the skin infection has cleared up and she is "back to herself" I'm not sure why she is still there. I would speak to the Director or Nursing and request that she be discharged.
Medicare does not pay 80% when its rehab. They only pay 50%. Secondary may pay the other 50% but that depends on your contract with the secondary. My Mom's did not pay so Mom owed the balance. The 80% and 20% are for medical bills.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
They will cover another 80 days at 50% IF progress is being made.
This is after a qualifying hospital stay of at least 3 midnights of hospital admission NOT observation.
I learned to ask early on "my mom is being admitted, right?" and once I was told yes, I took down the name of the medical person who told me that, just in case.
Rehab does not cure. Their job is to try and get the person back to be as independent as possible. Sometimes that doesn't happen. A person will plateau. In the elderly an illness and a hospital stay can take a lot out of someone. Sometimes they never get back to who they were before the illness. Medicare determines when the person is discharged from the reports they receive.
Medicare pays 100% the first 20 days, 50% the 21st to the 100th day. The other 50% is paid by the patient or if lucky the secondary picks it up fully or partially. Its been 5 yrs but my Mom paid $150 a day for the time she was in over the 20 days. That mounts up.
As Mysteryshopper says you can be released for non-compliance. You have 3x you are allowed to turn down therapy.
"Her skin disease has since cleared up and we are trying to get her released, how do we legally get her released? She wants to come home and we have family that lives with her and takes care of her..."
Who is making her stay? Why are they making her stay? Or has it just not been discussed with her? If she's competent, she can request discharge. If she's not competent, her medical POA can request discharge.
You indicate she's been there a month and her issue has cleared up. Since that's over 20 days, there will be a bill. I would be rattling the admin cages to find out why they still have her there.
I do remember the hospital stay had to be “admitted” and not “observation” for 3 full nights in order to qualify for rehab.
Just read your profile. Talk to the Director of Nursing and request that she be discharged. That there are people who live with her who can handle any care she needs. In home can be set up to check on the rash. She will be seeing her PCP. And if money is a problem, tell her that. Even if not, I would tell them she does not have the money to stay any longer. No, you do not want to apply for Medicaid. She wants to go home.
Rehabs are not prisons. But, they can't make an unsafe discharge. So comply to anything they suggest. We had one poster where all they had to do was prove they set up an aide. I told them to set up the aide, when LO got home then cancel it. There are no Rehab police. But they are a business. And they will milk Medicare and insurance as long as they can.
You may not want to go Against Medical Advice because they do not have to send you home with any prescriptions or set you up with in home care. But you can go AMA and just see her primary ASAP. He/she can set her up with what she may need.
You have me curious now so please update us on how this goes. Oh, if they still won't release her callyour State Ombudsman.
Medicare Advantage programs have very different guidelines and you will need to carefully read their contract to see their monetary and time limitations.
If the skin infection has cleared up and she is "back to herself" I'm not sure why she is still there. I would speak to the Director or Nursing and request that she be discharged.