Weekly Tips & Insights

What to Know About Medicare's New Rehabilitation Standards

Premature Termination of Coverage

Medicare offers skilled rehab services to their beneficiaries, which also cover room and board at nursing homes throughout the period of receiving these services. However, for over 15 years, most skilled nursing homes have been prematurely and incorrectly terminating this benefit because the patient has “plateaued” or “is not improving.”

Lawsuits Against Termination of Coverage

This has been the topic of a federal class action lawsuit, Jimmo v Sebelius, (D. VT, 1/24/2013). In this case, the plaintiff, Mrs. Jimmo, was told by her nursing home that her Medicare rehab benefit (and as a result, coverage of her stay at the home), were being terminated due to her lack of progress in her skilled rehab sessions.