Dear Ms. Stein,
I am an advocate for seniors. I wear many hats in that capacity. I am the Public Policy Chair of the Minnesota Board on Aging and the founding director of a newly organized nonprofit serving seniors. I am writing to thank you for the information you have on your website that helped me empower a distraught family so that they could effectively advocate for their mother's Medicare benefits.
… A few weeks ago, I received a call from a friend whose mother was told she might soon be released from a rehab facility if she did not show improvement (following surgery where the doctor ordered that she bear no weight for 90 days and receive PT, OT four times per day). She was not only told she might not be able to stay in her rehab bed, but neither could she private pay for the bed. She felt threatened that she might be asked to leave the Transitional Care Unit and was told one option might be that if she wanted to stay in the facility, she would have to transfer to the long-term care SNF unit, possibly as a private pay patient.
I went to your website and downloaded the Improvement Standard Self-help Packet and discussed it with the family. I was amazed at what happened next. When we spoke with the social worker, she admitted, "I don't know the Medicare regulations, I've never read them." The family was able to stand up for their mother's Medicare benefits by outlining, point by point from the self-help packet, the reasons why she met the skilled nursing care coverage criteria. The social worker quickly backed down from threatening that the mother be moved out of the rehab bed. The decision to move the patient was delayed until after the follow-up appointment with the doctor a week later.
At the next medical appointment, the family was able to effectively communicate with the doctor and the orders did not change (no weight, PT & OT 4x per day). To everyone's relief, the patient is still in the rehab bed. The extra 70 days in rehab will be covered by Medicare and the co-pay will be covered by their supplement… a tremendous saving for this family.
There is so much Medicare advocacy work that needs to be done. I thank you for the high quality, timely and useful information you make available on your website.