My 91 year old Mom fell and broke her hip, she was placed in a skilled nursing facility for rehab. On Thursday we get a call from them saying her time is up today and they found her a long term bed at a place 20 minutes away. We politely told them no one made us aware her time was up and that we would not approve transfer until visiting the long term facility. They told us we could have until Monday to get her out, still NO paperwork outlining her discharge etc. we did not like the long term care facility suggested, and looked over the weekend to find her somewhere else. WE have also thought about appealing for more rehab time, but we can not even do that without a formal written discharge. Now they called us yelling telling us she has to leave today. Can they just kick her out if we don't have a place for her to go? Can we get them for not giving us written notice about her discharge? Our problem is we can't find any places that take Medicaid pending, so we are trying to explore our options, whether that be an appeal or a Medicaid lawyer. We just need one or two more days and are willing to pay for them out of pocket. We just don't even know where to go from here.

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Medicare will only pay for rehab as long as there it's improvement. Once the patient plateaus they need to be released.
Helpful Answer (0)

I am sorry that you are going through this stressful situation!
Facilities that accept Medicare must give notice and if you disagree with the decision you have options, but you have to move fast.
There is something called a Fast Appeal. Here is the link:
It says:
While you're getting Skilled Nursing Facility, HHA, CORF, or hospice services, you should get a notice called "Notice of Medicare Non-Coverage" at least 2 days before covered services end. If you don't get this notice, ask for it. This notice explains:

The date your covered services will end
That you may have to pay for services you get after the coverage end date given on your notice
Information on your right to get a detailed notice about why your covered services are ending
Your right to a fast appeal and information on how to contact the Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO) in your state to request a fast appeal
Follow the link to the Medicare site I gave and read about your rights. then go to the BFCC-QIO site they mention:
You will choose your State, then go to the pull-down and choose the BFCC-QIO option. You will get a resource in your State to help.
In the meantime, call and ask to speak with the discharge planner and let them know you have not received the legally required Notice of Medicare Non-Coverage.
Best of luck,
Helpful Answer (2)

Care facilities need to be paid for every day they care for a patient. When insurance is no longer covering the care, they cannot keep the patient. I think it would have been smart for them to give you a lot more notice that this time was approaching and this conflict could have been avoided. Have you assured them that you will pay for the extra days yourself?

They did find a place for her to go. I don't think they have more responsibility than that.

What were you planning for after her discharge? Is it a surprise that she needs a care center? Have you been searching for one since she entered the rehab center, or did you have a different vision for what would happen at the end of rehab? Is the medicaid application process well under way?

What kind of options do you think you can come up with in "one or two more days"? I think any appeal would have to be on the basis that she needs more rehab and that she is making progress. I don't think not having found another place would be grounds for an appeal. An Elder Law attorney could advise you on that, and help with the Medicaid application process. I think that is who you should consult next. But it isn't even certain that you can get an appointment in one or two more days, let alone have a solution. A lawyer will be very helpful, but that won't make more Medicaid-pending beds open up. I guess if I were the Rehab center hearing you say you only needed a couple more days I would believe that your intentions were good, but not that you could live up to your intentions.

Perhaps your mother will have to take the opening they found, at least temporarily while you find a better solution. Could that work out, do you think?

I am so sorry that you are facing this stressful and challenging situation. I wish the facility had been in better communication with you and also explained from the very beginning the expected length of her stay. But wishes don't change things. See an Elder Law specialist as soon as possible.
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