Our mom fell and broke her pelvis. The orthopedic surgeon said it is inoperable and she needs to stay off the impacted leg for 6 weeks. She was sent to a TCU, and has been there about two weeks. The staff at the TCU is saying that unless she shows progression in the next two weeks transferring from a bed to a wheelchair and a wheelchair to the toilet that Medicare will not pay for her rehab. She's in her mid-90s. It's close to impossible for her to stand on her non-impacted leg, keep the impacted foot/leg off the floor and transfer. I was told by a very competent physical therapist at the hospital that almost no elderly person can do this. This discharge policy makes no sense to us. How can she be designated as "making no progress" when her doctor has said she can't stand on both feet? I'll call Medicare but does anyone have experience with this? They say to send her back to the assisted living and get rehab but PT only comes once or twice a week to the assisted living, so I don't think they will progress her. There is some rule that you can return to a TCU within 30 days (maybe with a doctor's order) and Medicare will not require the usual three midnights in a hospital to cover TCU, but I'm not really sure how that will work. This is all very frustrating. The way things are going, she's going to be bed bound and using a commode. All of this is made more complicated by the fact that she has (not severe) dementia. Any advice or thoughts? Thanks.
A Transitional Care Unit is for exactly this kind of situation, where the patient needs medical care but isn't able to do full on rehab yet.