My late 90 year old wife, who was confined to an Alzheimer's Ward for two years, and was given 59 of Self Care/Home Management sessions over the first six months of her stay. Medicare Summary Notices reported payments of $1443.00 to the nursing home.and our co-payments were $360.00. The co-payments were waived after I complained. Half way through the six month period, my wife fell and broke her shoulder becoming immobile and unable to participate. However, Medicare was continually billed for over 515 Physical Therapy sessions totaling $12,500.00 through this same period. Although Medicare yearly limits for this therapy were $1840.00, the nursing home was claiming these treatments were medically necessary. Can anyone explain how that could be?