Mom is in a long term care hospital in Houston, I'm in Dallas. I also have my handicapped sister who lives with me. I would like to have mom moved to a LTCH here in Dallas so my sister and I can be involved in her recovery. I was told Medicare would not cover this because it was a "lateral transfer." If the hospital here has beds available and I have a physician who is willing to take her...what is there not to cover?
Medicare has at least one peculiar rule regarding Long Term Care hospitals. If an individual for whatever reason needs to be transferred to another LTC hospital, it can't be the one from which he/she was just previously being treated (which isn't your situation, but I'm mentioning it just as an example of the different rules that apply to LTC hospitals).
This happened to my father, in Select Specialty Hospital, renting space from a St. Joe's Hospital. After developing and recovering from VRE, and being transferred from the SSH floor to ICU, someone at SSH (probably a social worker or someone in the billing department) advised me that Dad couldn't return to that SSH. I had to find another one, which I did, 30 miles away. It was a much longer drive, but in a medical community renowned nationwide for its higher level of care.
That doesn't apply to your situation, but I mention it b/c that Medicare rule for LTC hospitals seemed to be to be a bit bizarre. There may be other rules specific to LTC that are equally peculiar. Transfers at the LTC level aren't comparable to those at a regular hospital level.
I believe it was a LTC acute care hospital, but don't recall; this was over a decade and a half ago.
There might be something similar regarding a lateral transfer. I would definitely contact Medicare directly, and confirm in writing if you do get a positive response.
Then ask the doctor who scripted for LTC to script for it at the hospital closer to you.
And confirm with the LTC billing department of both hospitals, just to be on the safe side.
Your plan makes a lot of sense to me; I think it would be easier on everyone.