The Medicare rehabilitative stay benefit provides coverage for up to one hundred (100) days for a patient in a nursing facility. There are situations where the one hundred (100) day benefit can be renewed. However, this is not common. Moreover, often families hear “one hundred days” and expect that the benefit will cover a full one hundred (100) days. It is not common for a patient to receive the full one hundred (100) days. While each recipient’s situation is different, many only receive thirty (30) days of assistance or fewer.
There are many reasons for this. The patient may not cooperate with care. This can end the benefit almost immediately. The recipient may not respond to the rehabilitative care in a way that shows the care is either improving or maintaining their condition. This can end the benefit with little notice. Also, Medicare terminate coverage early because the recipient’s condition not improving. This is referred to as “plateauing.” It is the wrong standard.
The one hundred (100) day Medicare benefit does not mean that the family has one hundred (100) days to plan for long-term care. When someone enters a nursing facility, planning should begin immediately. Families often end up acting on a much shorter timetable than expected when Medicare coverage ends early. The patient is best served when planning is done in advance.
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