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Paid Medicare, medically exercise therapy at assisted living facilities for 102 yr old putting on 40lbs last yr. Ambliory with JAZZY scooter.

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Did a medical practitioner write a prescription for therapy?
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Yes, 5ft, near 102 year old Brite lady only gets around on her JAZZY scooter, NOW, she arrived at AL,, two years ago WALKING with "sticks" short distances, getting in to a car for a drive, inside to shop for holiday presents & few personal items. These trips were short timed, but she was using her whole body to navigate, using her JAZZY when she was just getting around facility. Arriving there weighing about 150lb. She now weights 199lb AND can't/doesn't want to walk anywhere, NOW w/weight. No diabetes, no heart issues, and takes 2advil a day. Since, March 2020, facility has been on safety COVID19 lock downs. We've seen her 4xs face to face with outside 30min. appointment sit downs, highly restricted "TENT VISITS." No contact. We respect this.
This is a very nice AL facility with meals of residents choice. We've eaten with her many times in private dinning room, BEFORE COVID19. The choices have many fried, breaded, high caloric meals, with ice cream, cake, cookies...ect. More snacks before bed.. Couldn't the nutrientist/chef supply pleasing choices like they do for diabetics and other lower heathy caloric diets to help with this continued weight gain? We'd like the 30min exercise program on bike and other means to help her lose weight as Dr. prescribed, instead of dressing her in a clothes from OMAR the tent maker. Mom is a prideful lady, wishing to look nice with hair done, jewelry, ect. Maybe a visit to a professional nutrientist would back up Dr's. prescription the AL facility would not be dragging their feet?
At our most recent "care meeting" 2 days ago,(we haven't seen her since summer in person, only ZOOM, which always bombs) The "care squad" all spoke of her weight gain. 199lbs. They request we buy her a bigger wardrobe
for easier dressing. $'s is not the problem for clothes: OVERLOADING her body with breaded gumbo, lard infused entrées and ice cream +snacks is contributing greatly to being self contained in her chair watching tv or transferring to JAZZY, buzzing around limited to get around her room(bathroom, chair, and bed, down to dinner, if available do to protection of COVID19.
Sorry, back to EXERCISE. The total all points exercise bike room is right across the hall w/tv, music. She would need a skilled attendant/therapy person to help her on and off & get her on a reasonable program. I believe this extra personal interaction would help keep her mentally stimulated, too. Along with pride of accomplishment. Many benefits could be achieved. This facility has a $30 for 30 minutes offering exercise, does MEDICARE pay for any of therapy? And under which circumstances? Thanks for taking the time to get to know me & MOM! PLEASE HELP.
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She is 102 years old? Usually people at that age are losing weight, not gaining. If she WANTS to lose weight, then she needs to start by adjusting her diet. Exercise can only do so much (this is a scientifically proven fact). If YOU want her to lose weight because it is bothering YOU, I would drop it. At 102 she gets to do what she wants and has to accept the consequences of having her mobility end. Also, at 5' and 199 lbs, I'm not sure she can even safely stand (or has the musculature to do so without a LOT of PT). No where in your post did I get a sense that SHE wants to lose the weight. Therefore you will be banging your head against a brick wall, pushing a donkey uphill, whatever idiom you wish to employ.

"The total all points exercise bike room is right across the hall w/tv, music. She would need a skilled attendant/therapy person to help her on and off & get her on a reasonable program." Your mom would be a 2-person assist. I highly doubt she'd even be able to get herself onto the bike. There is such a thing and a portable peddle exerciser, where the person sits in a normal chair and peddles the device with their feet just like a bike. Again, she needs to want to do it herself. There are a lot of rules about "withholding food" at facilities. I realized my MIL was starting with dessert and then not eating the rest of her meal. She was gaining weight. I asked could they please give her the tray of food without the dessert on it until she ate some of her main course. Nope. They can't even do that.

I get what you are worried about, we had a similar situation in our family. My MIL just decided she didn't ever want to get out of bed again even though there wasn't anything physically preventing her. Now she is bed bound with short-term memory loss. Only gets in and out of bed with a Hoyer lift. I'm so sorry you have to watch this happen to your mom, with her willing participation.
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Nice they have an exercise room. But I don't think staff is obligated to help her in using it. These are aides and maybe an RN. They are not trained therapists.

When Mom was in an AL, I was able to get her a doctors order for "in home" therapy. The facility she was in was affiliated with Fox and they came in to do the therapy. Same with her daycare, they obtained a Drs. order and called in a local therapy group. Medicare and moms supplimental paid for all but maybe $20 a session. Mom had a share deductible. She had to pay half of the 20% Medicare didn't pay.

Moms AL had a nutritionist off sight. If you get a drs order concerning what foods she should be eating, the AL should abide by it. Talk to the RN.
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Amounts of time for rehab allowed by medicare is a formula. Do check at 1-800-medicare to see if the time allowed has already been used. You will need to let the Rehab facility know, or they will let you know if she is private pay, or how many days can be covered by Medicare. It is generally 20 days I believe covered IF she is adjudged to be capable of any rehab by the facility. And then, when discharged, she must not need to use rehab for I think it is 60 days before getting rehab covered again. Please don't take my word for it; it's 3 years since I had anything to do with the formula. Call Medicare and check on rehab payment.
As I said, complicated. She must be capable of rehab in the opinion of the therapists at the rehab in order to stay in the program some weeks. She may not qualify with her age and weight.
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