SNF & Hospice

I was just going through the same thing with my mother. She was living at home, with an aid and hospice services, but after a series of events she ended up in the hospital with a need for 24/7 care. Similar situation of bed sore/no longer able to ambulate/toileting issues compared to where she was before. She has Medicare and Medicaid, and was presented with a choice for transfer to SNF: 1) stay on hospice and enter the facility under long-term care with no rehab, which would be covered by Medicaid, or 2) revoke hospice and enter the facility under Medicare, which would pay 100% for up to 100 days as long as she was on therapy. She has hopes of regaining some function, and so she chose the latter. My understanding is that without Medicaid option 1 would have required out-of-pocket payment for the SNF, because Medicare won't cover it. With option 2, the main consideration is the medication management, since the facility would be taking over her prescriptions, so we made sure we found a place with a good doctor who won't leave her in pain. Medicare will also stop covering as soon as she is terminated from therapy (either because of refusal, lack of progress, or meeting all her goals). But I was told that it would not be difficult to go back on hospice when that time comes, so overall it seemed like the way to go for now.

You could leave her in SNF but the cost of the SNF comes out of Moms pocket. Medicare does not pay for the facility only when recieving rehab. I would ask the AL if she would be allowed back if she qualifies for Hospice. Otherwise, Mom will be paying OP for the bed with Medicare paying for Hospice. That could be 10k a month. If she runs out of money, then u apply for Medicaid.

It's all so confusing! I'm a little confused by your question, since MediCare is a payor, and hospice is a program that Medicare covers. Maybe the confusion is that while medi-care covers Hospice services, they will not cover the room and board at a nursing home, you would need to also have medi-caid to cover that portion. Maybe I just confused things more!?