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I received a call this afternoon from the facility my mom is at - indicating her formally approved care is terminating on 2/7/2022. She was approved until 2/15/2022. I have POA for her and act as her agent. The facility had my mom sign the Medicare Non-Coverage form, I believe understanding she did not know what she was signing. My mom has dementia, is prone to falling, wanders, amongst other health issues.


Is there anything I can do about this? Should I retain the services of an attorney?

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So, have you inquired why termination? Is she not progressing?

Do you have POA?

What is the discharge plan?
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Thanks for answering. I do have the POA, and the nursing facility also has a copy.
I was not given a reason, nor a discharge plan.

The facility had my mom attempt to sign her name, and my mom is so advanced in her dementia, she signed in her maiden name.
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Can you please confirm that you are talking about Medicare and not Medicaid? If Medicare, assuming she in a facility for rehabilitation?
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CoffeBean1209 Feb 2022
This is for Medicare.
She originally went into the hospital because she fell - three times in four days. The hospital discharged her to the Medicare/Medicaid facility for therapy. I was told she was to be assessed for a week then they would get back to me with a care plan. That never happened. Now I get a call late on Friday - that her services will cut off on Monday.

That really does not give me any time to do anything other than try to appeal. But I still can’t get over the fact the facility had my mom sign something she was incapable of understanding; when I have the POA for her.
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I am I similar situation with my mom. You have the right to appeal the notice of non-coverage. The information should be on the notice explaining how to appeal. I appealed first notice twice and got coverage for 2 more weeks. Then second notice came and I am on the 3rd appeal, which actually goes to a judge. I appealed through Livanta Quality Improvement Organization. Go online to enter appeal because contact information will depend on your state.
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Besides what others have written, especially about appealing to Medicare, I think there are a few issues you might want to address personally: in terms of your involvement.

1.   Why didn't you contact the rehab facility when no care plan meeting was actually held, despite having been told ithere would be one?

2.   I think there could be a legal challenge based on your mother's mental state, but doing so is going to be costly.   And as already mentioned, she may have plateaued in her recovery.

3.    Same factor would apply to appealing the discharge.  It could cost more than a week or so of daily costs.

4.   Another factor exists:   you might have trouble finding an attorney to take this case; they're in business for a reason, and if there's not a good chance of recovery, a case like this wouldn't appeal to them.

In addition, an attorney would likely ask the same questions asked on this forum, as well as in this post, such as why no follow-up was done when a care plan meeting wasn't held, as well as how often you visited to monitor her progress, speak with the therapists and keep up to date on her progression.

I write this not to be cruel or critical of your role, but just to present another viewpoint, and one which the facility may very well take.
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