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My 83 mom has just been moved to a SNF for rehab after being in ICU for 2 weeks. Her rehab will most likely be at at minimum 2 weeks. I know Medicare will pay for 20 days at 100% and then an additional 80 at 80%. She fell, broke 11+ ribs, punctured a lung, and has mitral valve regurgitation. Despite all these issues, she is of sound mind, and I anticipate she may refuse treatment in the SNL after a couple days. If she does, will Medicare cut her off from future SNF benefits?

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Frankly, I don't blame your mom though I've terribly sorry that she has to go through this. I disagree with lying to your mom since she's cognitively sound. She will not lose all of her Medicare benefits and she likely knows that. However, she will likely lose her place in the facility if she refuses the treatment. She can apply for private pay admission.

She sounds as if she may be ready for hospice care, though a doctor would need to decide if she qualifies. Since she still has a good mind, she has a right to decide what she wants. She may want to go home, but Medicare will cover hospice care there or in a nursing home if she needs to go into the facility (this would be private pay). If she improves under hospice she can go off the program.

Listen to what your mom wants. This is her life and she is in a very miserable condition. Her mental capacity is sound but her body is not. She'll know where she wants to go from here.

My best to your both. This is very hard.
Carol
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OmaFeef, I found this for you https://www.medicare.gov/coverage/skilled-nursing-facility-care.html ;  it says  "If you refuse your daily skilled care or therapy, you may lose your Medicare SNF coverage".

Also "If you stop getting skilled care in the SNF, or leave the SNF altogether, your SNF coverage may be affected depending on how long your break in SNF care lasts."

"If your break in skilled care lasts more than 30 days, you need a new 3-day hospital stay to qualify for additional SNF care.   The new hospital stay doesn’t need to be for the same condition that you were treated for during your previous stay."
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Will she agree to have in-home OT, PT and Visiting Nurses? Will she comply with their recommendations for exercise?

Before she leaves the SNF, arrange to have the OT assess her home for safety. Discuss with discharge planning who will be at home to assist. If she is planning on going home alone, you can indicate strongly that you will NOT be moving in to care for her.

In any event, feel free to TELL her that she will lose ALL her Medicare benefits if she leaves prematurely. Sometimes you gotta do what you gotta do to keep Mom safe, if not happy.
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When you are of "sound mind" you can refuse treatment from any medical provider. I just took my husband out of a SNF because of poor treatment and I refused all medications they wanted to give him. Of course I'm the "sound mind" acting on his behalf.
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Of course, you will check with the facility to be sure, however, when my mother was in a skilled nursing facility after leaving the hospital, they said she would have to demonstrate progress. Get the social worker involved immediately, if you haven't already. These people are angels and can help you navigate the system and also keep check on your mother's mental state to avoid depression. Know you are not alone, though days can get overwhelming.
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When my father was in the nursing home after having been in the hospital, they attempted physical therapy with him. However, the therapists gave up after a few attempts because he was, in their words, simply unable to do anything, which was true. We learned that Medicare will only continue paying the 20 days/80 days if the patient is progressing, so he lost this. After my mother had been in the hospital and returned to the nursing home, they attempted therapy with to get her strength back up (she had been in the hospital for an unrelated reason), but because one of her legs hurt so much when trying to walk using a walker (both femurs had broken spontaneously due to severe osteoporosis a few years earlier at different times, and she had metal rods installed in each leg), she refused further therapy and effectively resigned herself to being bedridden (which, of course, she still is after 3 years). Medicare quit paying for her nursing care, but I didn't have to heart to tell her she essentially threw $16K out the window by quitting--maybe if this had been explained to her earlier, it would have given her a bit more incentive to try--but I'm not the one having the painful leg so perhaps this would have been cruel to suggest!
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freqflyer said it all. Listen to her.
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Rehab in a SNF and being in a SNF for care are two different things.
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You can refuse care just make sure a doctor signs off. No one can make u go to rehab. I agree, see about home therapy.
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bigsispjt

Not all Social Workers are as you described.
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