I did put the money down on AL, my mom is agreeing to go, now, it appears the AL is dragging their feet a bit, though I may misunderstand, on getting the nurses intake evaluation.
The upshot is she is supposed to leave rehab on Wednesday per he Medicare Advantage plan company, but will not be able to go to AL then
The AL director says the rehab place cannot discharge her if the AL is not ready to take her, but what then?
Can she stay there for a couple more days? Who pays? She has not reached the 21 day limit for medicate pay for rehab but was leaving as medicare thought she was ready to leave.
Private pay on that could be spendy
And of course there is always the appeal process if for some reason Medicare is not willing to work with your mom until she's placed.
At the rehab my mom is at now, the nurses, aides, therapists, all wonderful both in their professions and in terms of say a bedside manner for lack of a better term
But this SW has been asleep at the job . I finally called my moms Medicare Advantage provider to initiate an appeal which they did. The SW thinks I a meddling and I wanted to (didnt) tell her I would not be meddling if she was doing her job
The SW said yes, but private pay which could be hundreds per night which is not good . This rehab and the AL, indeed the social worker from rehab and the director at AL are close, about a mile apart, and a pipeline of people going back and forth all the time, I assumed the AL Director (who also oversees admissions for the IL my mom has been) were on the same page
I am wondering if I can call her medicare advantage partner to appeal .
That did happen five years ago when my mom was in rehab and we asked for another day do to logistical reasons. The social worker worked with insurance to make that happen .
This SW doesnt seem to try, though maybe thats her job
Call the Medicare advantage plan immediately and find out how much they have paid out already to the rehab.
In all likelihood the rehab is pulling the popular little trick that care facilities like to do when a resident is going to be discharged.
They will bill the full amount and Medicare pays it. Then they collect it in cash from the resident. After the check clears, they evaluate the person and happily discharge them into rehab.
So you tell the social worker who's going back and forth and spinning everything to keep your mother from getting evaluated and discharged, that the rehab isn't getting a cent in cash until the nurse has evaluated your mom and you've checked with Medicare to see how much they've paid.
Trust me, they will get that evaluation done. Don't pay them anything in cash until you've spoken with Medicare and found out how much they've shelled out because they may be owed nothing in cash.
Also, its not 21 days its 20. 21 starts the 50% Medicare pays.
Yes, call her insurance. I have done it and they took care of my problem. They pay the bill. They have the ability to penalize the Rehab. Rehabs contract with these insurances. I too agree that there are good ( have only dealt with a few) and bad ( deal with a lot more than good) Social Workers.