Hoping this link works! Basically it says that Medicare should not be denying therapy and skilled care coverage just because a patient no longer is showing improvements.
Your thoughts?
That’s very interesting, and helpful. Looks like the original settlement happened just about the time that my dad was having his final and prolonged stay at skilled nursing, and would have spared me lots of stress and endless conversations about what was going to happen when his 100-day rehab claim ended with him still far too sick to go home. (That was the other problem – even if you were improving, after 100 days, you were dropped.)
The way it was explained to me was that the purpose of Medicare skilled nursing coverage wasn’t to house someone indefinitely, maybe for years, but to pay for their recovery/rehab. Once there was no hope of improvement, Medicare would no longer pick up the tab. As a taxpayer, that made sense to me at the time – think of the astronomical cost of housing every elderly sick person in the country for months or years. But it left us in a terrible bind since Dad staying in skilled nursing without Medicare would have run $9K/month for God knows long. He passed away on day 85 or so, so in the event we were never actually faced with the decision.