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My mom is being discharged from rehab on Tuesday. She's considered medically complex. The physical therapist is telling me that she may become more exercise tolerant as time goes on, but she really doesn't think that mom's going to make a big bit of improvement. So we will have things like PT and OT covered until she can go to outpatient if she can go to outpatient. She's currently considered homebound by her doctor, but I think it has to be recertified every time you go to the hospital. I'm not entirely sure how that works. But my mom is currently at assisted living and they want me to hire help more than them and I was wondering if I could have Medicare pay for some of those hours so I'm not paying out the ass for home care which is already ridiculously expensive and on top of her rent and current care plan. I don't know if it's feasible for me. She doesn't qualify for Medicaid and she makes too much money right now for any agency on aging program. She's just barely over the cap. The money she does have goes to her rent and her care level at her assisted living facility. What are my options here and what does it look like price wise to get a HHA to come in a couple of hours a day? Will Medicare cover any of this and for how long? And after the period that they cover, is it possible to have a doctor recertify her for the continued care or does it just have like a limit in a 100-day. Like the rehab does? I only found out she's being discharged on Saturday so I could call a lot of people but I hadn't received any calls back no one really works on weekends here and that kind of sucks. But if anybody could offer me some information I would be very grateful. She's not able to be returned to my care I don't have a way to put her on the first floor of my home. That was also an option and unfortunately it's not one that I can do at this time. Additional information she currently receives dressing help, bathing help, laundry assistance, minimal house keeping, all meals, and assisted transfers from her assisted living facility but because it's assisted living they're limited in the services they provide.

Medicare pays for "in home care" after a hospital stay. A doctor can order it. Its only a tempory fix. Mom can get therapy and an aid for bathing but that us maybe 3 hrs a day. Medicare does not notpay for daily care. If the AL cannot provide Mom with the care she needs it may mean a Longterm care facility. You spend down her assets then apply for Medicaid. If her monthly income is too much, maybe your State allows a Qualifing Income trust or Miller trust.
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Reply to JoAnn29
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In my experience, a lot depends on your mom’s insurance. Traditional Medicare will likely cover more therapy than a Medicare advantage plan. I was appalled by the limited services some plans would approve, and that was over two years ago. The nurse or therapist who opens your mom’s case can determine homebound status, it doesn’t need to be a physician.

Have you spoken to the rehab social worker? They are the ones that should have information on what to do going forward. Unfortunately, hiring private caregivers is expensive, and most agencies will require a minimum number of hours daily, usually around four. I wish I had better news to offer. I think you are absolutely right to not attempt caring for her in your home, as it’s more than one person can do in a sustained way.
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Reply to MidwestOT
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It sounds like ALF isn't the correct level of care for mom here at all.
What Medicare help she can get sadly is up to your own research on all of this, and highly dependent on whether she is in an advantage program or on regular medicare with good but expensive supplemental NOT advantage type. It's complicated and not something we can answer.

If mom has too much for medicaid and no other assets for her needed outside expenditures, that is to say if she is cash-rich monthly from pension and SS but asset-poor then she won't be able to afford either a nursing home or MC placement on her own, and likely won't qualify for Medicaid. If this is monthly income see a CELA certified Elder Law Attorney to work out a Q.I.T. or Miller Trust so that mom can have some of the monthly assets put in that trust and qualify for Medicaid. This will likely mean a move from ALF/MC as they are expensive monthly, usually corporate owned, and don't accept Medicaid.

Being in CARE and NEEDING MORE CARE is not sustainable.
If you are currently using your own savings, earnings funds, do know that is a dreadful mistake and will leave both YOU and your mom dead broke. Fine for her as she will then get medicaid and she has had her life, but your years of needing care are ahead of you and you will need a LIFETIME of hard savings to get the care you need in future.

I am sorry. You are in the middle of it now. And you need to get down to basics. Mom needs a level of care in which she can affordably live even if with the help of governmental support. You need to save for your own future. The fact is that this can go on for many years, even a decade, with mom never getting any better and never getting a good deal worse. I am so very sorry.

In the end were I writing one sentence here (and I never write only one, ha ha) it would be "see a CELA Elder Law attorney for discussion of assets, insurance and options."
I sure wish you luck.
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Reply to AlvaDeer
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