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My mother was in nursing home for rehab after 70 days she was taken to hospital because of blood clots inlegs she returned to nursing home after 5 days in hospital.
Dan - mom's ICD codes are key to determining status. ICD will be pretty easy to find within her medical chart. Most likely could be in its own block with the heading "Admitting & Associated Diagnosis". It will be something like: M54.12 (which is cervical radiculitis). There will likely several ICDs. So try to look at moms chart, if there's overlap on any codes, then the new hospitalization & discharge is part of initial admit. Or ask SW or the RN who is the floor nurse to look at her chart to determine.
It sounds like your mother is being treated within the same "spell of illness."
Medicare pays for "inpatient hospital services, post-hospital extended care services, home health services, and hospice care . . . post-hospital extended care services for up to 100 days during any spell of illness..." 42 U.S. Code § 1395d(a)(2)(A) - Scope of benefits https://www.law.cornell.edu/uscode/text/42/1395d
42 USC Section 1395x(a) defines the term “spell of illness” as a period of consecutive days— (1) beginning with the first day (not included in a previous spell of illness) (A) on which such individual is furnished inpatient hospital services, inpatient critical access hospital services or extended care services, and (B) which occurs in a month for which he is entitled to benefits under part A, and (2) ending with the close of the first period of 60 consecutive days thereafter on each of which he is neither an inpatient of a hospital or critical access hospital nor an inpatient of a facility described in section 1395i–3(a)(1) of this title or subsection (y)(1). https://www.law.cornell.edu/uscode/text/42/1395x
If your break in skilled care lasts more than 30 days, you need a new 3-day hospital stay to qualify for additional SNF care. The new hospital stay doesn’t need to be for the same condition that you were treated for during your previous stay.
If your break in skilled care lasts for at least 60 days in a row, this ends your current benefit period and renews your SNF benefits. This means that the maximum coverage available would be up to 100 days of SNF benefits."
Confirm with your health care providers whether your mother's care was within the same "spell of illness."
And, if she was at the hospital for 3 or more days, check to see if they "admitted" her under "observational status". Even though she was there for 3 or more days, if she was under observation, it will not count towards the required 3 day admit stay and thus the 100 days for a follow on rehab stay. Also, the rehab stay is only for 100 days if she continues to need SKILLED rehab or nursing and if she does not show improvement within that 100 days, then she could potentially be discharged or taken off the Part A portion of that Medicare benefit. Talk to a hospital ombudsman for information as it pertains to your Mom's situation.
This information should be helpful! There's some fine lines in how Medicare pays for the care that's needed. Follow this link: http://www.aarp.org/health/medicare-insurance/info-08-2010/ask_ms_medicare_question_86__.html hope this is helpful!
The hundred days only starts over if she was admitted for a totally different condition. From what you stated, I can only assume she is back in the same place for the same condition, so no restart.
My understanding is that she must have not just been admitted to the hospital, but, must have had a stay of 3 days or more in the hospital for acute care
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:
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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").
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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.
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APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
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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.
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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.
ICD will be pretty easy to find within her medical chart. Most likely could be in its own block with the heading "Admitting & Associated Diagnosis". It will be something like:
M54.12 (which is cervical radiculitis). There will likely several ICDs.
So try to look at moms chart, if there's overlap on any codes, then the new hospitalization & discharge is part of initial admit. Or ask SW or the RN who is the floor nurse to look at her chart to determine.
Medicare pays for "inpatient hospital services, post-hospital extended care services, home health services, and hospice care . . . post-hospital extended care services for up to 100 days during any spell of illness..."
42 U.S. Code § 1395d(a)(2)(A) - Scope of benefits
https://www.law.cornell.edu/uscode/text/42/1395d
42 USC Section 1395x(a) defines the term “spell of illness” as a period of consecutive days—
(1) beginning with the first day (not included in a previous spell of illness) (A) on which such individual is furnished inpatient hospital services, inpatient critical access hospital services or extended care services, and (B) which occurs in a month for which he is entitled to benefits under part A, and
(2) ending with the close of the first period of 60 consecutive days thereafter on each of which he is neither an inpatient of a hospital or critical access hospital nor an inpatient of a facility described in section 1395i–3(a)(1) of this title or subsection (y)(1).
https://www.law.cornell.edu/uscode/text/42/1395x
From Medicare.gov:
https://www.medicare.gov/coverage/skilled-nursing-facility-care.html
"If you stop getting skilled care in the SNF, or leave the SNF altogether, your SNF coverage may be affected depending on how long your break in SNF care lasts.
If your break in skilled care lasts more than 30 days, you need a new 3-day hospital stay to qualify for additional SNF care. The new hospital stay doesn’t need to be for the same condition that you were treated for during your previous stay.
If your break in skilled care lasts for at least 60 days in a row, this ends your current benefit period and renews your SNF benefits. This means that the maximum coverage available would be up to 100 days of SNF benefits."
Confirm with your health care providers whether your mother's care was within the same "spell of illness."
http://www.aarp.org/health/medicare-insurance/info-08-2010/ask_ms_medicare_question_86__.html hope this is helpful!