My father has not yet used up his 100 days of rehab he is entitled to. They called me Thurs and told me he is going home Tuesday because he has met his goals. He lives alone and his bedroom is on the second floor. They only started doing steps with him a week ago. He is there after heart surgeries and multiple complications. Tonight he was out of breath just from walking to the bathroom and eating dinner. He has no coverage for a home aide and limited funds but too much for Medicaid. We also went through terrible experiences with Home aides for my late mother.
I asked the rehab to give him just another week or so at rehab ao he can build up his strength a little more and they refused - made me file an appeal with an outside agency which I lost. Now there is a second appeal but I will not find out until tomorrow and they release him Tuesday. I spent the day yesterday cleaning his house from top to bottom in case I lose again and am off to a 24 hour supermarket to buy food for him and bring it there. I am so angry and disgusted by our health care system that doesn’t give a crap for the patient and does not look at them holistically. And I am shocked because my mom was in the nursing home section of this rehab for two years before she died, and my husband was also there after a bad accident so they know my family very well. So I feel betrayed also. Any advice? I was told if I lose the next appeal we will have to pay for extra days he is there. But I believe if he goes home now I will be back in the ER with him again, or worse. I have no strength left. I am an only child with no local family so it is all on me.

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You can't blame the rehab. Medicare determines who continues in rehab based on info they get from the therapist at rehab. Did they call it goals or plateau? Plateau means there is nothing more they can do for him and Medicare has agreed. No one is entitled to 100 days that just means Medicare will pay up to then.

You say heart problems with complications? Does Dad have congestive heart failure? There is not much you can do when the heart is not doing what it is suppose to. Check and see if Dad can get home therapy. They will evaluate Dad and the therapy will take into account what he will need to get around the house. He can get an aide too. Is there an area downstairs that can be made into a bedroom? Is there a bath downstairs?

Your other option is using what money he has to pay for LTC. If he brings in monthly more than Medicaids maximum then check into a Millers Trust. This is where the extra goes into the trust which goes to Medicaid at time of Dads passing.

Did you talk to his therapist? Ask her why he is being released when he has hard time getting around? Does the therapist know he is going home to a 2 story house?
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I don’t believe it is correct that on a miller trust, the money goes to Medicaid at the time dad passes. The monthly income actually goes into the trust and goes right back out to the nursing home as dads “share of cost” Every month. And then when he dies, whatever is left goes to Medicaid.
I'm sorry you are going through such a difficult and stressful time helping your father get the care he needs. Do the appeal processes consider not just rehab options but whether your father is capable of self care? Does your father's doctor(s) have a voice in the discharge and appeals?

Call your Area Council on Aging and ask what adult day care or rehab or in home care programs are available without Medicaid qualification. If that doesn't get you any help you may want to consider APS, sometimes they have different "immediate" services (many short term) that are not income based but need based. You may not feel your dad is ready for day care but one in our area has a nurse present all day and lift recliners for participants so they may be able to meet his needs better than you might think. Sounds like even a week or two at this point would be very helpful. I would also check with local churches or volunteer EMT organizations to see if there is someone (maybe retired) who could help your dad for a few days.

If paying for the extra days is beyond your father's means, consider asking distant family if they could help cover some of the cost for that extra week. If your father is a retiree from a company that has a retiree group, you might consider asking for help there too.
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