My stepdad spent three weeks in a physical-therapy facility for his hip and knee problems. Mom told me that Medicare would pay for 21 days. On Day 21 (which might have been Christmas day), Stepdad fell and broke his shoulder there. As a result, he spent three days in the hospital and then was returned to the same facility.
I told my mom that I remember reading on this forum that there is something significant about staying three nights in a hospital in regard to being discharged--maybe to a rehab facility or nursing home. Maybe that they qualify for Medicare-paid therapy in a facility after three nights in a hospital? So maybe Medicare will pay for another 21 days since he has a new injury for which he was hospitalized? I know this is a vague question, but of what significance are those three nights? Of course, Mom will find out soon regarding payment, I'm just trying to remember what I read.
Stepdad's brother lives in city near Mom and Stepdad, and has become involved in Stepdad's future. This includes moving Mom and Stepdad to an AL community near Brother when Stepdad is able to do so. Meanwhile, Mom is making do with home-healthcare workers two days a week. Since she has Parkinsonism, I hate for her to be living alone for fear of a fall, though she says she is fine with the setup.
That's very interesting what you said about Mom being the Community Spouse and splitting the assets so Stepdad can apply for Medicaid. They have some savings but we all know it will go fast! I will pass this advice on to Mom. Thanks.
Sounds like ur Mom will not be able to care for SD. This would be the time to have him placed in LTC. Mom would be the Community Spouse. She will not be left impoverished. Assets will be split with his split being spent down and then apply for Medicaid.
Your profile says you live in separate states. You may want to go there so ur more hands on. This is probably overwhelming for Mom.
I think that your stepdad's care in the rehab facility will be partially but not fully paid for by Medicare. My understanding of the rules is that Medicare pays in full for the first 20 days in a skilled nursing facility (e.g., rehab) for a "spell of illness" and then pays in part for the 21st to the 100th days. In your stepdad's case, I think that the new injury will be considered part of the same spell of illness as the original reason he was in rehab, because of the 60-day rule: "A 'spell of illness' begins on the first day a patient receives Medicare-covered inpatient hospital or skilled nursing facility care and ends when the patient has spent 60 consecutive days outside the institution, or remains in the institution but does not receive Medicare-coverable care for 60 consecutive days."
But....in order for Medicare to "re-set" and restart the clock, the patient must have been out of care (out of the hospital and out of rehab for I think 60 days).
Have you or mom talked to the discharge planning folks at the hospital about this? Was dad about to be discharged from the rehab or was he about to be approved for further coverage? How was it that he fell?
You might need to play some hardball with the rehab center to get them to cover this stay if the fall was due to negligence.
How is his stay being paid for now?