Shar54 Asked July 2014
Can the 100 day rule be extended?
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A friend has been hospitalized with a stroke, TIAs and pneumonia on two recent occasions. He is currently in a rehab center for the second time. He has been told he will need to leave because he has used up his 100 days in his two stays at the rehab center. He has a feeding tube. He is not able to walk independently or walk steps. What options are there for him?
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If he is on Medicare (over 65), then he can also look for getting onto hospice. He will need a doc referral for hospice can be done. Hospice is an 100% benefit from Medicare BUT hospice does not pay for their room & board costs of a facility. That would come from Medicaid, or private pay or long term care insurance. My mom is on Medicaid in a NH and since last year on hospice (Medicare), & the NH seem to really like having hospice involved as it provides for a lot more care and outside staff to attend to their residents.
Really the social workers know quite a lot of info and often I've found they will say things somewhat more bluntly or clearly as they are required to be on staff for the state to license a facility so their jobs are outside somewhat of the geo-politic of the nursing staff or admissions.
Good luck in all this & thank goodness you are there for him.
You can (a) ask your friends cardiac or pulmonry doctor (b) call Medicare directly, although you might need to provide specific case information on your friend's situation, and unless you've filed a POA with Medicare they won't give you specifics, just generalities, or (c) check the Medicare and You 2014 booklet.
You, or his family, could talk to his physician (cardiac, perhaps) about a long term care hospital. Select Specialty Hospitals are that kind of hospital. There used to be one in Pontiac, on the 7th floor of the St. Joseph Mercy Hospital on Woodward. Although I haven't checked recently, there also was one in Macomb, and an excellent, topnotch one at the St. Joseph Hospital in Ann Arbor.
(I see you're in my "old stomping ground area" and assume your friend is also in that area.)
My father was in two of them over a decade ago, but I don't recall the financial arrangement other than the fact that at one point his Medicare coverage was exhausted and he had to pay out of pocket. However, he had no Medigap or supplemental insurance at that time.
Another option is to ask his doctor to script for home care, although it won't be easy if he can't walk independently. Does he have anyone at home to help him?
Huron Valley Sinai Hospital, literally in your back yard, has a pulmonary rehab program on site. Medicare pays for it w/o time limitation, so at least that would provide help for that issue. He would have to be able to go or be driven to the hospital (or other facility) to participate in the program. If you need to know the name of a good pulmonary doctor at HVSH, PM me.
In general terms of options, though, I think a lot depends on his home situation. If you could provide some information on whether or not he has someone at home to help, it would also help anyone who wants to offer suggestions.