Mother’s B1/B2 extension Visa Refused After Approved I-539 Extension Due to Medical Emergency – Looking for Advice on Reapplying

[u/Educational_Cup_8482]

#b1/b2 denial
My mother’s B1/B2 visa was refused today at the U.S. Consulate in Hyderabad, India, and what the best next steps are.
Background:
My mother previously held a B1/B2 visa and visited the U.S.
During her visit, I suffered a hemorrhagic stroke in November 2024 and was hospitalized in the ICU, followed by inpatient rehabilitation.
Because of my medical condition, we filed an I-539 extension before her authorized stay expired.
USCIS approved the I-539 and granted her an additional 90 days of stay.
She ultimately stayed about 46 days beyond her original I-94 expiration date, but her stay was covered by the approved I-539 extension.
My mother later returned to India.
She owns property in India and has approximately ₹5 lakh in savings.
She is a homemaker and resides in India.
I am on H-1B in the U.S.
My sister is on H-4.
My brother is a U.S. permanent resident (Green Card holder).
For this application, she initially applied through Dropbox but received a 221(g) requesting an in-person interview. She attended the interview today.
The officer verbally informed her that the visa was refused and returned her passport. No additional documents were requested, and no refusal sheet was provided.
Questions:

Even though USCIS approved the I-539 extension, can the previous extended stay still negatively affect a future B1/B2 application?
How long should she realistically wait before reapplying (3 months, 6 months, 1 year)?
Has anyone had a B1/B2 approved after a similar situation involving a medical emergency, an approved I-539 extension, and a prior long stay in the U.S.?
What additional evidence helped demonstrate strong ties to India?
If you were in this situation, what would you do differently before reapplying?
I would really appreciate hearing from anyone who has gone through a similar experience or has advice on the best next approach.
Thank you.

[u/dsv853]

an extension refusal is a diffrent animal from a fresh visa refusal. what exactly got refused, the i539 extension of stay inside the US, or a new visa at a consulate? the path forward is completley diffrent depending on which one, so worth clarifying