If in an Assisted Living, but need PT in a Rehab, will Medicare pay for rehab if you are not in the hospital for the required time before rehab?

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My mother does not have medicaid only Medicare so am I on the right topic?? At present my mom is in an assisted living. Right now, age 99, she had fell and broke her hip in 2015, and in 2015 went into a rehab type Nursing Home. When her time was up to leave the rehab in 2015, during that time I had fell and hurt my hip so the assisted living had to be used. The Phy Therapy in Assisted living was not acceptable- in fact I had walked in several times sat in a corner they didn't know me & I watched. The lady did paperwork the time she should have been working with my mother. Also, did not work with her walking as the Rehab did. My mother could walk 90 feet with walker before but this place caused her to lose ability and muscle strength working with her arms; her arms had strength. So my question is, since my mom has AFIB, a calcified aortic valve, CHF, swelling in her feet will Medicare pay for a Physical Therapy stay in the rehab again without going in the hospital for the 2 to 3 day requirement I think that is in place, but not sure.


My mom does not look like 99, she is in activity everyday playing bingo, the horseraces, bowling, etc in her wheelchair and doesn't want to lay down when I have. The doctor has asked to have her feet elevated an hr in the am and an hour in the pm. She will elevate them sometimes but LIKES to refuse. I thought with dementia that her thinking not to elevate should not be concrete but what the doctor asked and what I asked the Assist Liv to do. So the Phys Therapy in the REHAB was excellent, but not at the Assist Living. So I need to know what this Forum thinks about this. I think the rehab could help her again gain more confidence and strength she lost and then go back into Assisted Liv, after the amount of days allowed in rehab to help her gain strength and walk with walker slowly.

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Assuming a doctor agrees, and would script for rehab, she can get it w/o having been through a hospital stay. And Medicare would pay for it. That's my experience.

However, you can always call Medicare or ask the doctor who might script for therapy.

I recently got home PT for my father, after the initial home care post hospital and rehab had ended. His therapist said she was able to bring him back to the level he was at a year ago, and I could see improvement as well. So it was worth it.

Ask your mother's doctor, perhaps the orthopedic one, to script for the PT while she's at AL. If he/she doesn't, try another doctor. You probably would have to bring her to the doctor's office for an exam, so be prepared for that outing.

Alternately, are there any doctors who are visiting docs at the AL facility?
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