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Autumn 2026·8 min read·Bruce Tollefson, Abloom Senior Living

When your parent breaks a hip

What the weeks after hip surgery usually look like, and how to line up help at home.

Who this is written for

A hip fracture turns into a logistics problem fast, usually while you are standing in a hospital hallway with your phone in your hand. Someone asks where your mother is going when she leaves, and you do not know what the choices are or whose job it is to arrange them.

You have not missed an obvious step here. The discharge gets planned in pieces, each piece explained by a different person, and the weeks at home afterward tend to get explained last.

Most people do not go straight home

A hip fracture almost always means surgery, and after surgery most people spend a few weeks somewhere before going home. In 2019 there were 290,130 hospitalizations for hip fractures among adults aged 65 and older, and 82.8 percent of those patients were discharged to another facility such as a skilled nursing or rehabilitation unit, according to a CDC analysis of hip fracture injuries among older adults published in the Journal of Aging and Health.

So when a discharge planner tells you your mother is going to a transitional care unit in Woodbury or Maplewood for two or three weeks, you are hearing the ordinary path for this injury. Families often take it as a sign that something went wrong in surgery, when it usually means she needs daily therapy and cannot get it at home yet.

Ask about the billing rules for that stay in the first week, because they surprise people. Medicare.gov states that Part A covers care in a skilled nursing facility only after a qualifying inpatient hospital stay of at least three days in a row, that observation and emergency room hours do not count toward those three days, and that coverage runs up to 100 days in a benefit period. For 2026, Medicare.gov lists days 1 through 20 at no daily cost after the Part A deductible of $1,736, days 21 through 100 at $217 per day, and the full cost from day 101 on.

Coverage can run up to 100 days, and most people are discharged well before that. If the day 21 figure is the one you are stuck on, ask the unit's social worker in the first week how long they expect her to stay. They can usually give you a range.

The harder part starts the day she comes home, when someone has to be there at seven in the morning and at nine at night.

What Medicare covers at home

Medicare does pay for home health after a hip fracture when the conditions are met. Medicare's own description of the home health benefit requires three things: a provider must see your parent in person, certify the need, and order the care; she must need part-time or intermittent skilled services such as nursing or physical therapy; and she must be homebound, meaning leaving home takes considerable effort. A Medicare-certified agency then sends a nurse and a therapist on a visit schedule.

What that benefit does not include is the rest of the day. Medicare.gov states that it does not cover 24-hour care at home, homemaker services such as shopping and cleaning unrelated to the care plan, or help with bathing, dressing, and using the bathroom when that help is the only care your parent needs. Home health aide time is covered only alongside a skilled service, and it ends when that service does.

Your father can therefore have a physical therapist in the house three mornings a week and still have nobody there to get him safely to the toilet at two in the afternoon. Home health and personal care are separate services with separate funding, and families usually need both. Home care or home health covers the distinction.

The first two weeks at home

The therapy visits get scheduled for you. The hours in between are the ones you have to arrange yourself, and they are easier to arrange if you know what tends to go wrong.

Transfers come first. Getting out of bed, off the toilet, out of a chair, and into a car are the risky moments for a healing hip, and they are also how a tired daughter ends up hurting her own back. Some parents need two people for a few weeks. Personal care at home is scheduled around those moments, so someone is in the room when she stands up.

The bathroom is next. Most people come home with a walker, a raised toilet seat, and a shower they cannot step into safely. If the only full bathroom is upstairs, decide before discharge where she will sleep and bathe for the next month. Plenty of families put a bed in the dining room for six weeks, and that is a reasonable thing to do.

Nights are the other problem. Pain medication, a full bladder, and an unfamiliar walker in a dark hallway make three in the morning the riskiest hour of the day. Some families cover nights themselves for a week and then stop sleeping. Overnight care at home is staffed as awake shifts, which is usually what a hip needs in week two.

Equipment usually arrives over several days, from more than one supplier. Ask the hospital or the transitional care unit what is ordered, what is delivered, and what you are expected to buy. Write it on the refrigerator. Then put the walker, the commode, and the phone charger within arm's reach of the bed, even if the room looks cluttered. Nothing about this has to look tidy for a while.

How much help, and when

Most families guess low at first, which is reasonable when nobody has told them what the hours actually look like. Most families here buy heavier coverage for the first two or three weeks on mornings and evenings, then cut back once she is steady on the walker and the therapist signs off. Mornings tend to matter most, because bathing, dressing, and the first transfer of the day all land in the same ninety minutes.

You do not have to settle the whole schedule before she comes home. Start with the hours you are sure about, usually the morning routine and whatever covers the stretch when you are at work, and adjust in week two. Hours at home walks through how families in Washington County typically build a week.

What a Minnesota agency has to do before and after it starts

You do not have to learn this list. An agency owes you these things without being asked, and knowing them helps you spot one cutting corners.

A comprehensive home care provider in Minnesota works under chapter 144A. Under Minn. Stat. 144A.4791, a registered nurse must complete an in-person initial assessment within five days of the first visit, a written service plan must be finalized within 14 days and signed by the provider and your family, and the nurse must reassess in the home within 14 days and then at least every 90 days as needs change. The statute also requires the agency to give you the home care bill of rights and a written statement of what its license permits before the first visit.

Tasks like tube feeding or wound care fall under Minn. Stat. 144A.4793, which lets a licensed health professional delegate a treatment to unlicensed staff only after instructing them for that specific client, writing the instructions into the record, and confirming the staff member can do it competently. If an agency cannot tell you who the supervising nurse is and when she will be in the house, ask again. If you still cannot get a straight answer, call someone else.

Ask any agency you call whether they will staff a two-person transfer, because not all of them will. Abloom Senior Living does, under a comprehensive home care license from the Minnesota Department of Health.

Paying for it

Care at home after a hip fracture is usually private pay, sometimes with a long-term care insurance policy behind it. If your parent has a policy, dig it out this week. These usually sit in a file cabinet nobody has opened in a decade. Most policies pay a daily or monthly benefit after an elimination period, and the claim needs documentation from the first day of care, which is hard to reconstruct a month later.

If your father is a veteran or the surviving spouse of one, VA Aid and Attendance is paid to him directly as an addition to his pension; he pays the agency himself, and the care invoices document the unreimbursed medical expenses in the claim. On our end, Abloom Senior Living takes private pay and long-term care insurance for care at home. If your parent needs waiver-funded help, we will say so and give you a referral. Paying for care covers the other routes.

If home turns out not to work

Sometimes it does not work, and it is easier to talk that over with your family in the next week or two than during the next emergency. A hip fracture at 86 sometimes shows that the house was already hard for her before the fall. If that is where this ends up, you will know within a few weeks, and you are allowed to change the plan without feeling you failed at the first one. There are good small settings in the East Metro if it comes to that, including a five-resident home Abloom Senior Living runs in Woodbury. We are glad to name others, whether or not you end up working with us.

Where to start this week

Find out the discharge date and whether a home health order is being written. Decide where your parent will sleep and bathe. Then line up the mornings and the stretch that you cannot cover yourself. That is enough for this week, and the rest can wait until you can see how she is moving.

If you want help thinking it through, you can request in-home care and we will talk through what the first two weeks would need, what we would charge, and whether we are the right fit. If we are not, we will tell you and point you somewhere better. You are also welcome to ask us to come to the house, or to come see the Woodbury home. Minnesota Aging Pathways, the state's free resource line for families, is at 800-333-2433 and takes these questions all day long.

This article is general information from a care provider in Woodbury, Minnesota. It is not legal, financial, or medical advice. Coverage rules, benefit amounts, and your parent's clinical needs vary, so confirm specifics with the hospital, the insurer, or a licensed professional.

Frequently asked questions

How long does a parent stay in a transitional care unit after a hip fracture?

Two to three weeks is common, though it depends on how she does with therapy. Medicare.gov states that Part A can cover up to 100 days of skilled nursing facility care in a benefit period, and most people are discharged well before that. Ask the unit's social worker in the first week what length of stay they expect.

Does Medicare pay for a caregiver at home after hip surgery?

Medicare pays for home health, meaning skilled nursing and therapy visits, when your parent is homebound and a provider has certified the need. Medicare.gov states that the benefit does not cover 24-hour care at home, homemaker services unrelated to the care plan, or help with bathing, dressing, and using the bathroom when that help is the only care needed. Hands-on help through the rest of the day is usually paid for privately.

How many hours of home care does a parent need after a hip replacement?

It varies with the surgery and with how steady she is, so it is normal not to know at discharge. Many families start with mornings and evenings for the first two or three weeks and adjust once the therapist has seen her at home.

Can my parent be left alone after hip surgery?

That is a question for her surgeon and therapist, since it depends on her weight-bearing restrictions, her balance, and her medications. If she needs help to stand up safely, she should not be alone for long stretches, and nights are usually the part families underestimate.

Who pays for in-home care after a hip fracture in Minnesota?

Most families pay privately, sometimes with a long-term care insurance policy. Minnesota waivers and Medical Assistance pay for in-home services for people who qualify, which is handled through a county assessment. Minnesota Aging Pathways can explain the options at no cost.

Related reading

Sources

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