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Did the doctor who performed the surgery either provide a statement, or something to the rehab facility advising that she's to be non weight bearing? He or she should be involved, to affirm the non weight bearing status so PT can continue on strengthening w/o weight bearing.
My mother experienced this; we went back to her ortho doctor; he wrote a statement and we delivered it to the rehab facility.
We had also gone back to him b/c a therapist determined that my mother wasn't able to progress. The doctor's letter and our challenge addressed that. He was placed at another facility and my mother got a new therapist, a very compassionate one.
I agree that coding is involved, but so is the doctor.
This is about correct coding. She was apparently admitted to rehab for rehab, that is to say for walking and getting around again. However they code that. But she cannot now participate. If she cannot improve through rehab, yes, Medicare will not pay. Are there open wounds of any kind? Is there anything you can think of that you could ask the MD to use to "buy" her more time? Why is she unable to put weight on this surgical leg? Does anyone have any idea? If not, I am afraid she will be discharge, in a WC and possible forced to use a wheel chair ongoing. Is she suffering from dementia? How old is she? Are there other conditions as well?
This is the old "no improvement", "plateau", "new baseline" BS that many facilities still try to shovel. Don't fall for it. Medicare themselves tell you how to fight it. Note that the first two appeals are by another private healthcare provider so you will tend to lose those. The third and up are by the government. Your best chance is when you hit those. The law is pretty clear. Also, a written appeal seems to work better than an oral one over the phone. When I did the oral one on the phone, I read a statement I wrote citing all the relevant laws. The person on the other side didn't seem to be doing any typing and at the end, she just said "The family disagrees." Not surprisingly we lost that appeal.
Here's the medicare website giving you links to information you need to appeal this. Call your city or county ombudsman as well. But don't be surprised if they've never heard of it either. Mine towed the "no improvement" line as well until he looked into all the pointers I gave him, consulted a lawyer and then he called back and told me I was right.
Do you think the Lawyer consult was what tipped it into the "winning" because I haven't heard of anyone winning yet. Hope they have good luck here. But one can also understand that, if someone cannot participate in rehab therapy, the Government wouldn't want to pay for that specialized care, and would think they have reason not to. The appeal is sure worth a try but I would hesitate to hire a Lawyer and invest that; I think the ombudsman is an excellent idea.
Are you saying she is in a rehab facility post operative to regain mobility. But the rehab is saying shes not improving? And so now the Medicare coverage is ending due to lack of improvement? I believe theses evaluation periods usually occur every 2 weeks, so you may be able to appeal to Medicare/supplemental insurance provider to ask for another few week increment. What is the facility recommending for “next steps”? Others may chime in with more info, or please clarify if I haven’t understood the situation correctly.
If the PT people are charting that the patient cannot participate and they do not expect that to change then it can happen. When people go to rehab and think they can refuse PT or not participate it can happen fairly quickly but there is usually care plan discussion, often family asked to participate in planning first. At least my experience of it in California.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
My mother experienced this; we went back to her ortho doctor; he wrote a statement and we delivered it to the rehab facility.
We had also gone back to him b/c a therapist determined that my mother wasn't able to progress. The doctor's letter and our challenge addressed that. He was placed at another facility and my mother got a new therapist, a very compassionate one.
I agree that coding is involved, but so is the doctor.
Why is she unable to put weight on this surgical leg? Does anyone have any idea? If not, I am afraid she will be discharge, in a WC and possible forced to use a wheel chair ongoing. Is she suffering from dementia? How old is she? Are there other conditions as well?
Here's the medicare website giving you links to information you need to appeal this. Call your city or county ombudsman as well. But don't be surprised if they've never heard of it either. Mine towed the "no improvement" line as well until he looked into all the pointers I gave him, consulted a lawyer and then he called back and told me I was right.
https://www.cms.gov/Center/Special-Topic/Jimmo-Center.html
Others may chime in with more info, or please clarify if I haven’t understood the situation correctly.