Case Study: Teaming up on a difficult discharge from skilled nursing
Helping families in Vermont find senior living and care options for their older loved ones
CarePatrol of Vermont was contacted by the family of their 89 year old mother in late November, 2024. She had been visiting in Burlington over the holidays and had a fall and broke her hip. She was admitted to UVM Medical Center for surgery and initial treatment and then was transferred to skilled nursing in Burlington for additional Post-Acute care and physical therapy.
While she was in skilled nursing, her Medicare Advantage Insurance provider informed her that they would only cover a limited number of days in skilled nursing. This was far too little rehabilitation time according to her doctors and an appeal by the family to her provider was declined.
Their mom lives in Florida and flying home this soon was not a viable option as she currently lives alone in her home. Further, staying in skilled nursing was going to be extremely costly once her insurance stopped coverage. Staying at her son’s home was not ideal because there are a lot of stairs to navigate in the home. Her son wasn’t sure what to do next and mom was to be discharged within the next four days.
The Approach:
- Chris Foran, a Certified Senior Advisor (CSA)® reviewed the entire case using CarePatrol’s care discovery process and suggested that the family consider a short term respite stay at an assisted living community in the Burlington area.
- We reached out to several communities in the area, but short respite stays are challenging in Vermont due to low availability. We finally zeroed in on a great community that could provide a respite stay solution. The community really stepped up and had an apartment fully furnished and ready within 24 hours.
- She moved in and fit into the community right away. She also began receiving third party physical therapy treatment services at the community.
The Outcome:
Her Medicare Advantage provider stepped in again and limited the number of days of additional physical therapy they would authorize to be paid in the community. The family had been paying privately for respite care but needed the insurance coverage for her physical therapy. Fortunately, with two weeks of additional respite care after being discharged from skilled nursing, she was well enough to travel back to Florida. The families mom is finally home again and doing well.
At CarePatrol we help families find appropriate independent living, assisted living, memory care and in-home care. Our local team does this all over Vermont.
- We review the care and violation history of the communities with whom we work.
- We tour our clients to recommended communities much like a realtor tours with families to show new homes.
- We are a free service to families as we are compensated by the thousands of communities that we work with nationwide.
If you have questions or need assistance for your senior loved one, reach out to us as a resource.