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peace416 Asked July 2021

Can a physician order a rehabilitation center stay for a patient even if the patient was not recently hospitalized for their illness?

LO is 74 year old with debilitating peripheral neuropathy. Thank you.

Firstof5 Jul 2021
Check with the insurance company about coverage requirements. My mom was denied coverage for rehab care when she was in the hospital for 3 days because it was coded as "observation."

peace416 Jul 2021
Thanks NeedHelpWithMom:

LO (sister) has original Medicare with Medicare supplement. I believe there’s a 20 day minimum on rehab. As I replied to Momheal1, she was hospitalized in May, had home PT. Also home health aid for bathing, etc. However, she now seems to be back to square one. Can’t get appt with PC until end of next week. Alternative -another ER visit. I’m going to suggest she contacts her neurologist maybe get an earlier appt.

Her health issues are many: lupus, polymyositis for many years. Recently PN, cellulitis (foot wound - no diabetes), lower leg pain.
NeedHelpWithMom Jul 2021
You certainly have your hands full. That’s an awful lot to deal with. I hope that your situation improves.

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Momheal1 Jul 2021
I have encountered the same thing - for inpatient rehab there has to be a 3 night hospital stay. My mom is also 74. You can start with home health or even a local outpatient rehabilitation center with a script from her doctor.
Sometimes it’s better to start with in home therapy (even for just one certification period which is usually 3/4 weeks) this sometimes allows them to get them a little stronger so they can build up strength to then meet the “goals” once they get to an outpatient rehab. With all the goals and guidelines set with insurance - I try to get moms stamina up with home health and then move onto outpatient so that she gets always has a better chance of achieving higher rehabilitation when she arrives at outpatient.
NeedHelpWithMom Jul 2021
Plus, the doctor can reorder home health when needed. My mom did it several times. They could always get her to do so much more than I ever could.

This is funny. My mom was in her 90’s, had Parkinson’s disease, was nearly deaf but I swear that she knew a good looking guy, when she saw one. Home health sent really handsome physical therapists to our home!

Same thing with the firemen! They were great looking guys. They aren’t out of shape like many police officers.
MJ1929 Jul 2021
I suppose they can. I suppose it depends on the treatment being given. Not everything requires hospitalization first.

NeedHelpWithMom Jul 2021
Not sure, but they can order home health, which is a good start. Rehab is more extensive. They both have occupational and physical therapy. Home health will even send an aide to help with bathing if needed.

When mom was in the hospital, they said that it required a ‘three day’ stay before entering a rehab facility. They gave me a list of facilities to choose from. I selected one and they brought her to the facility by ambulance.

Maybe insurance plays a part in it too. My mom had Humana Gold Plus.

Tell us more about your circumstances.
peace416 Jul 2021
Hi - thought I posted reply to you but my “answer” to you is above. 🙃

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