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To try to make a long story short, my mom has MS, broke her hip, and decided not to have surgery. She is in a rehab that she is very unhappy in, and I have been very disappointed in the administration there. That as well as a $25 a day fee for a private room. We want to transfer her to a new rehab that I have friends of family who went there and had a very good experience. The private room is also no extra charge, and that is a big thing also for us.

So talked to the social worker at her current rehab (she is very difficult to get a hold of or get a straight answer out of). She told me that Medicare might not change over with her to the new place. She also told me that I am the one who has to set up and pay for my moms wheelchair transportation to the new facility.

Does anyone have any experience in anything like this that could give me some advice on whether what the social worker tells me is true? I do not understand why Medicare would not move over with her. I was also told by the place she is moving to, that her original rehab should take care of her transportation.

I want to be prepared with as much knowledge about this as possible before I speak again with the social worker Monday.

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Usually, the only way Medicare will cover rehab is when someone spends 3 days/3 midnights in a hospital, is discharged directly to a rehab, and is improving daily as a result of skilled therapy/treatment. If she moves at this point, it may not be an "eligible" stay due to the lack of the 3 day hospitalization just now.
Call the SHIP number for more info on this. SHIP is a free health benefits counseling service for Medicare beneficiaries and their families or caregivers. SHIPs mission is to educate, advocate, counsel and empower people to make informed healthcare benefit decisions, funded by Federal agencies and is not affiliated with the insurance industry. State Health Insurance Assistance Programs (SHIPs) provide free help to Medicare beneficiaries who have questions or issues with their health insurance. Go to: to get your local office phone number. They will know what the rules are for Medicare to pay for your mother’s rehab.
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EBeach you must be absolutely clear that the new place will take MedicAID and not just MediCARE or Medicare Advantage or private insurance.
You also need to be sure the new PT provider there takes Medicaid.
Huge differences between the plans!!
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I had very much the same experience at mom's subacute rehab place. The sw was a total ditz, this fact was totally reinforced a year later when my mom was hospitalized. The sw ' s mom was also in the hospital. I witnessed very inappropriate behavior on the part of this woman toward staff.
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Okay, I will. The discharge person at her current facility is the social worker and she is very difficult to get a hold of and a straight answer out of. Very frustrating. I feel it is the social work who should be the one I should be able to go to about anything. She has Medicaid, but not nursing home status. The new place told me they would help me with that once she is there.
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Not sure. I would be talking both to new facility and to the discharge folks at her hospital about how best to handle this. Are you applying for Medicaid, too?
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She is not at the twenty day mark, Monday she will be on day 13. She is definitely not ready to go home. As of now we only told her current facility she wants to move because of the $25 a day fee, although there are multiple reasons. I am curious if them filing it as only that reason could get it denied. The dr also has to approve the transfer and she will hopefully do it Monday.
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Transportation. When we transferred my mom from acute rehab to subacute, I had to arrange an ambulette. I know we submitted the bill to medicare but I don't know if they covered part of it or not. It seems to me that if mom is covered for rehab through Medicare, the insurance would follow her. Can the new facility check into that for you? It's in their interest to get this paid. Please make sure that you personally don't sign as financially responsible.

I would ask the social worker why she thinks medicare wouldn't pay for the new rehab? Is mom past the 20 day mark? Is current rehab planning to discharge her as medically fit to return home? Do they feel she's plateaued and no longer qualifies? How they complete their paperwork has a real impact on mom's eligibility, so find out!
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