My father fell and broke his hip and he needs nursing home care. I was told that he will be provided 100 days of Medicare coverage, is this correct?
ATTORNEYS MICHAEL CARTER and JEFFREY SCHLAPP:
This is a great question that many people are given misinformation. Medicare Part "A" covers skilled nursing services for the first 20 days at 100% of charges as long as the nursing home resident requires skilled nursing or rehabilitation services.
Medicare does not pay 100% of charges for 100 days. After the first 20 days, the resident is required to pay $124.00 a day and Medicare pays the remaining balance.
But keep in mind the nursing home resident must make progress and require skilled nursing or rehabilitation on a daily basis, and the residents physician must re-certify his/her need for skilled care on the day of admission, 14 days after admission and then every 30 days.
This is why its very important for family members to participate in the residents care plan conference and rehabilitation programs so they may monitor the progress of their loved one.
Nursing homes commonly receive new residents who need extended care after a broken hip, but residents and family members cannot assume (or accept arbitrary promises) that facilities will aggressively and proactively develop a care plan and follow it on the patient’s behalf. You must actively participate and monitor your loved one’s progress.
If you suspect someone you know has been abused, neglected, or had their rights violated as a resident of a nursing home or assisted living environment, please call: (866) 228-5016, or send us an email.
About Michael Carter: A trial attorney with Horwitz, Horwitz & Associates, Ltd, Michael oversees the prosecution of cases of nursing home negligence and abuse. It’s not unusual for Michael’s cases to become “high profile” and precedent setting due to the unique and often difficult circumstances surrounding them.
About Jeffrey Schlapp: Jeff lends a compelling and invaluable knowledge base to the discussion of nursing home care within the state. Formerly the Vice President of a corporately-owned Illinois nursing home chain, Jeff became an attorney to accomplish what he could not from inside the corporate structure; improve the lives and care of nursing home residents by holding corporations accountable and forcing change through the court system.