My aunt's been getting physical therapy at the nursing home. Now they have refused it. She will have to move to a smaller room. Help - AgingCare.com

My aunt's been getting physical therapy at the nursing home. Now they have refused it. She will have to move to a smaller room. Help

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She lives at the nursing home. Physical therapy says that therapy won't help anymore. If she stays in the room she's in now, it will cost way above her means because Medicare won't pay for it. We have appealed therapy cutting her off because she was supposed to have it for another month.

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Not sure what that article is about, because I can't click on the link, but that is not true. Sorry. You are looking at long term care for your mom. That is covered by Medicaid and not Medicare.
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Medicare has dropped its requirement of "no progress, no pay." (see this explanation: http://www.kaiserhealthnews.org/stories/2013/june/25/faq-on-medicare-improvement-standard.aspx)

You might be able to appeal and have therapy resumed.

But it sounds like the real issue here is how to afford Mom's NH room. Is she on Medicaid? Will she need to stay in the NH indefinitely, or was she intending to go home after the therapy?

Give us some more details and perhaps someone can address the cost issues specifically.
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The physical therapist can not alter his records in order for your mom to stay at the nursing home. His license would be taken away and he could be charged with Medicare fraud. Going after the therapy department is not the right way you should be handling this. If you are going to be upset with anyone turn your anger to the government for putting such tight restrictions on elderly patients. They do it because they can and because so many people don't realize what they are doing until they have a parent of their own in a nursing home. It is hard to understand and for the young people out there who are making all the laws...they aren't thinking about nursing homes. Take you case and write it to your congressman, your senator, the president! Tell them that the law isn't giving the therapist a long enough time to work on their patients who are not improving as fast as the law says that they should be improving. A lot of times, it is the family who doesn't want to believe that their mom or dad is not improving. The mom or dad know the situation but the children find it difficult to understand. Often times the therapist are the ones who people want to dispose their anger upon. Can you talk to the nursing home about long term care? If she qualifies for Medicaid then she may be able to be moved to a long term bed and then once Medicaid kicks in, they will make payments retroactive to the day the transfer took place.
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I'm glad your aunt has you for an advocate. Medicare is regulating Physical Therapy for elders and according to Medicare regulations the elder must have rehab potential and be demonstrating progress toward rehab goals for her to continue to receive those services. The amount of time she "was suppose to have" is dependent on progress, it is not guaranteed. It is unfortunate that wasn't explained clearly to you at the outset. Please recognize that if you are successful in your appeal you will only be extending Medicare payment and keeping the larger NH room for a month.
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Was she improving? That is one reason they might cut PT off.

This is a common problem - that Medicare doesn't pay for long term care. Does she have assets? Have you talked her situation over with an Elder Law attorney?
Could she qualify for Medicaid?
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