Will Medicare Cover My Father’s Nursing Home Care After an Injury?



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?


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 it is 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.