Has anyone heard about Medicare relaxing the rules around care due to caronavirus situation? My mother is in a skilled nursing facility still within her 100 days. But they are nearing the end and she will be dismissed. She has not been able to do adequate PT because they are confined to their rooms, though they are still doing PT, what they can. The SNF is recommending assisted living next, which I feel she is borderline ready for that (still needs more care.) Yet, she hasn't been able to rehab properly (just my opinion of course.) I read where Medicare is relaxing some rules around SNF, but not this particular situation.
Ask the PT (or OT), how mom is looking in her chart before Covid-19 concerns threw off her rehab schedule. If she wasn’t quite meeting her “progress” points or stages, she could be already past rehab and just staying there because of Covid. Or if her rehab care had already reached or was close to reaching the “bundling” for units of care for her diagnosis, she’s past what her insurance will cover, and just staying there because of Covid. If she’s having her secondary insurance paying the 20% rehab copay - like BCBS or United - those usually do “bundling” approach for paying; its only so many sessions based on her diagnosis (diagnosis would be the ICD-10 code entered for her care). If she’s on bundling, I’ve found that’s really not negotiable.
You might want to have a needs assessment done for her. The facility can help this get done. Even if they are suggesting AL, you might want to have that confirmed independently. You don’t want to find having to move her into SNF or MC couple of months from now.
If she is still in rehab, the pandemic has resulted in drop of PT hours, for sure. 100% stoppage hasn't happened.
Just to let you know, the SNF makes most of its money while your mom is in its rehab wing. What placed your mother into the SNF? Are you confident that she can she live in the part of the facility where minimal exercise or contact occurs (assisted living)? Have her evaluated by an outside person to make sure she is being placed properly. If it's a medicaid approved facility, they are looking for private payers to boost revenue streams.
Remember the primary goal of a facility is to make the most money possible. So keep asking about her occupational AND physical therapy. Upper body is labeled, "occupational therapy," while lower body is labeled physical therapy. Our facility promises big yet deliberately yanks every possible beneficial expense.