✓ No improvement required. maintenance is enough
✓ PT, OT & Speech Therapy all covered
✓ Prevents falls, decline & hospitalization
LANDMARK LEGAL RULING
The Jimmo v. Sebelius Settlement
In 2013, the landmark Jimmo v. Sebelius settlement clarified that Medicare must cover skilled therapy services that maintain a patient's condition or prevent/slow decline. even when no functional improvement is expected. This ruling ended years of improper denials and established Maintenance Therapy as a permanent Medicare benefit.
Why It Matters
Benefits of Maintenance Therapy
Maintenance Therapy is one of the most underutilized Medicare benefits. and one of the most impactful for long-term quality of life.
No Improvement Required
Unlike traditional therapy, Maintenance Therapy does not require you to show functional improvement. Coverage is based on medical necessity. not progress.
Prevents Functional Decline
Regular skilled therapy maintains your current level of function and prevents the regression that leads to falls, hospitalizations, and loss of independence.
Reduces Fall Risk
Balance, strength, and mobility exercises reduce the risk of falls. one of the leading causes of injury and hospitalization in older adults.
Delivered at Home
Physical, occupational, and speech therapists visit your home. no transportation needed, and therapy is tailored to your actual living environment.
Fewer Hospital Visits
Consistent maintenance therapy minimizes ER visits and urgent care needs by keeping your condition stable and your body strong.
Improved Quality of Life
Maintaining functional ability means maintaining independence. the ability to dress, bathe, cook, and move around your home on your own terms.
Therapy Types
Three Disciplines, One Care Plan
✓
Physical Therapy (PT)
Strength, balance, mobility, and fall prevention. Maintains your ability to walk, transfer, and perform daily activities safely.
✓
Occupational Therapy (OT)
Independence with activities of daily living. dressing, bathing, meal preparation, and home safety modifications.
✓
Speech-Language Pathology (SLP)
Swallowing safety, communication, and cognitive function maintenance for conditions like Parkinson's, stroke, and dementia.
Appropriate Diagnoses
Conditions We Treat with Maintenance Therapy
Parkinson's DiseaseMultiple SclerosisChronic ArthritisStroke RecoveryDementiaCOPDCHF (Congestive Heart Failure)Chronic Neurological ConditionsPost-Joint ReplacementSpinal Conditions
Source: American Physical Therapy Association. Skilled Maintenance Therapy Under Medicare
Keep Moving. Stay Independent.
Contact us to find out if Maintenance Therapy is right for you. Our Nurse Navigator will confirm your Medicare coverage before care begins.