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What can we do? Will Medicare pay if the patient has emergency hospitalization post-AMA?

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If a person has a Medicare supplement plan, by law if traditional Medicare covers anything, the supplement has to pay the amount Medicare doesn't cover. A Plan G supplement should cover up to 100 days in rehab or a nursing home. A Medicare Advantage plan will probably be more skimpy and you'll probably have to beg for any coverage at all.
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JoAnn29 May 29, 2025
And, Medicare can have you discharged anytime in that 100 days if they feel you have progressed as far as you can or your not cooperating. Those 100 days are not guarenteed.
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SNF should be managing her blood glucose. Collect your data and make arrangements with social worker/case manager (might have to be through a hospital) to move her to another SNF. Report the problems and give evidence to the state once your loved one is moved.
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How did this patient with a glucose issue get into an SNF in the first place? We need more information and your updated profile to help you. You may, however, talk with an ombudsman or a social worker.

Thank you,
Patathome01
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JoAnn29 May 29, 2025
Not the Social Worker at the facility, they work for the facility and I have found the useless.
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If it is an SNF, collect your evidence and notify the ombudsman. Every state has them.
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What is AMA and SNF?
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MidwestOT May 26, 2025
against medical advice and skilled nursing facility
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Medicare and insurances will pay if you go AMA. So don't let the facility tell you otherwise. You can call 911 if you want, just don't expect the facility to take the patient back. Facilities are not prisons, you have rights.

Someone did say on the forum that if you go AMA returning to your home and are admitted to the Hospital again for the same thing you went AMA for, your hospital stay or your rehab may not be covered. So check that out with Medicare before you go AMA if this is true.
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Not sure your situation but leaving AMA insane situations can lead to Medicare refusing to pay. Start 1st by speaking to nursing administrator and go up thr chain of command. Also the doctor overseeing care. Ask for a patient care conference
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MaryKathleen May 25, 2025
Kalamazootx1, I called the medicare people about them not paying when you leave AMA. They said that as long as you are admitted, they don't care how you leave.

If you hear different from a good source let me know. I say this because I was going to take my late husband out of the hospital AMA. He is gone, however. I would not hesitate to take myself out of a hospital if I didn't like the treatment.
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Is this rehab? If you feel they are not managing patients glucose talk to the Director of Nursing and find out why. Maybe the facility doctor did not write an order. Orders get screwed up between the hospital and Rehab. Moms did. The Rehab doctor took it upon himself to change my Moms thyroid med orders that her specialist had in place. A GP overriding a specialist. Nurses cannot do anything without an order from a doctor.
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Is patient WELL ENOUGH to leave?
You give us no information about this "patient". How in the world could we guess at the efficacy of patient's leaving care that was prescribed for his/her own good?

Sorry, not enough information here to make a guess at this situation. SNF isn't a prison. If a person is well enough, competent in his/her own mind, he can do whatever he likes, including take a trip to Hawaii on a cruise liner.

As to guessing what Medicare will or will not do? Can't imagine. I would give them a call.

Whatever is happening here I am left just wishing you the best of luck.
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Are you this patient's PoA or legal guardian? Do you think the patient knows what they're doing (do you suspect they have cognitive impairment)? Why are they in the SNF in the first place? If the SNF isn't doing their job, has the patient or legal advocate involved an ombudsman? Regarding the Medicare question, the patient can call Medicare themselves and ask (or their legal advocate can)... if the patient has an Advantage or supplemental gap plan, the answer can vary and we can't know enough to give you an accurate answer.
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