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Sounds like you have a handle on the hospital bill, But be aware for the hospital, this can depends on if her stay was “under observation” which is a grey are for Medicare coverage OR if she was actually admitted and if so then it’s a covered under Original Medicare Part A benefits. If your State has those on Medicare and Medicaid run under a Managed Care Organization (Molina does a lot of these nationwide) you have to read policy terms.
For the NH/SNF, it will be dependent on how your States LTC Medicaid program administers its “bed hold” policy. What States do is breakdown “bed hold” into 2 categories: 1. Therapeutic Home Visits (which of course has an acronym….THV) and has a Physician approval requirement in the process. MD does not have to allow a THV. and 2. Discharge to hospitalization w/usually a fixed # of days allowed.
Just what your State does is beyond mucho importante in all this. For example, 3 States MS, LA & TX: MS: 15 days bed hold per hospitalization and per hospital visit. Beyond the 15 is considered discharged from the NH. THV is a max of 52 days plus Thanksgiving and Christmas 3 day wraparound so a max of 58 THV days. MS pays NH the regular full reimbursement day rate. To me, MS has a staggering # of THV days. but further west in Louisiana…. LA: 7 hospital bed hold days done as a “leave of absence” and paid at 75% of the reimbursement day rate. THV 15 days reimbursed at 90% and further westward…. TX: seems to be non-therapeutic recipient absences to an hospital are considered a discharge. This to me is pretty scary restrictive. So family needs to find out exactly if the NH considers a run to the ER/ED or an observational hospital stay to fall under therapeutic and if not what the NH wants to get paid to do a bed hold and be fully prepared to private pay to ensure their elder can return to the old NH. But in TX for THV, allowed to leave if the THV does not exceed 3 days. & reimbursement is paid for those days as if the resident was there with no fixed max # of days that can be THV. So in theory, a resident could go visit with family every weekend for THV.
For my mom, I did THV for her to go with me for a Saturday wedding in another county abt a 3 hr drive away. Me in my car, hubs & kiddo in another. And mom had been to these family members homes before and several times. Mom did get a note from the NH MD that she was fine to leave (Requested at her care plan meeting) and I got her meds from the floor nurse. What was really emphasized by the DON of the NH was that mom could not be picked up before 10AM on Fri and I had to have her back for Sunday dinner. The NH - like schools - have to do a daily census that is reported to the State in order to be reimbursed, aka “butts in beds” “butts in seats”. Fwiw on retrospect doing this was not the smartest idea even though she was still at the time very social and very ambulatory…. the bathing and bathroom runs were stressful. Thank goodness cars have baby locks as every so often when we would stop at a light, she’d try to open her car door. Fun times!
It is somewhat dependent on the state in which she is residing and the reason she is in the SNF. She is a full time Medicaid recipient in the SNF in NJ, the facility must hold the bed for her for 10 days even though Medicaid does not pay for the bed (prior to 2011, Medicaid would pay for the bed for up to 10 days). If she was only there for PT and Medicare was paying for her stay, this could be totally different as Medicare is paying for her in the hospital and they will not pay for two places. All of this is in reference to traditional Medicare. The hundreds of Advantage programs are all different and you would need to check with plan involved. You can always contact the Medicaid office in charge of your Mom's account (be prepared to wait as they are also understaffed) and ask the social worker when the day count starts and ends for your Mom. If she was only out for a few days she should be covered by Medicaid. Tell the facility accounting office they got it all wrong.
Medicaid will pay any charges that Medicare does cover in the hospital. She has no money so hospital cannot expect anything from her. Family is not responsible for any balances.
No, she is not responsible for the nursing home "holding" her bed for a few days because she went to the hospital. Medicare (if she has days left) and Medicaid already paid for her bed. They do not deduct the days she was in the hospital from what they pay to the nursing home.
Nursing homes, greedy and underhanded bloodsuckers that they all are, saw an opportunity to possibly shakedown your mother and her family for more money that they aren't owed.
Don't pay them a cent for the days she was in the hospital because they were already paid.
If they insist on being paid for the empty bed, request a statement of payment from Medicare and Medicaid before you pay anything. This will be proof that the nursing home got paid. Show it to them if they continue with their shameless shakedown.
I used to do this all the time when my parent was in the nursing home if there were Medicare days left for the year. There were many hospital stays in a short period of time even when he became a permanent LTC resident on Medicaid. They still tried to shake us down to pay in cash to "hold" the bed because all the money wasn't gone yet.
They never got a cent from me until I'd hear back in writing from Medicare and Medicaid showing what they paid. Every time there was a hospital stay, the nursing home also got paid by Medicare or Medicaid for the "bed".
Don't pay them anything until you've spoken to Medicare and Medicaid to see what they've paid. In my state if a person in a nursing home is in the hospital 3 days or more and they have days left on their Medicare, that pays for some days in the nursing home. Most states have some kind of policy like this with Medicare. Talk to Medicare and Medicaid. Get statements in writing before you start writing checks for something your mother may not even owe.
Medicare along with her supplemental insurance will cover most of the cost. Medicare will cover up to 100 days. You will have to pay out of pocket past that time and it's extremely expensive. If your mom is not going back home, you must find a personal care home.
The rules of the contract signed when she entered the SNF will spell everything out for you. Because all facilities differ, this would be a good question for the administration at your mom's SNF. Given your Mom is on Medicaid I think it will be understood that her monies are already forfeit to her care. I doubt you will receive any bills from anyone, and in any case, given mom really has no money and doesn't need good credit, she needn't pay any bills that come her way if she has no funds to do so.
Not necessarily, Alva. A person can already be on Medicaid in a nursing home but they will still try to shake the family down for more in cash.
If someone is not permanently in a nursing home, they are relentless and determined to keep them until every cent has been handed over.
You can never trust the people who run these places. Families have to be extra careful about every bill they are submitted because the LTC are never honest.
She is. The bedspace wasn’t used by another paying resident during her hospitalization, it was kept for her, therefore she still pays. Hope she’s doing better
No, not necessarily. In all likelihood Medicare and/or Medicaid already paid for the bed space when the mother was in the hospital.
It's easy enough to check and to get written proof of. What entitles the nursing home to be paid twice and double for the same bed space? Nothing. Never pay these people a cent until you see what other sources have paid first.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
For the NH/SNF, it will be dependent on how your States LTC Medicaid program administers its “bed hold” policy. What States do is breakdown “bed hold” into 2 categories: 1. Therapeutic Home Visits (which of course has an acronym….THV) and has a Physician approval requirement in the process. MD does not have to allow a THV.
and
2. Discharge to hospitalization w/usually a fixed # of days allowed.
Just what your State does is beyond mucho importante in all this.
For example, 3 States MS, LA & TX:
MS: 15 days bed hold per hospitalization and per hospital visit. Beyond the 15 is considered discharged from the NH. THV is a max of 52 days plus Thanksgiving and Christmas 3 day wraparound so a max of 58 THV days. MS pays NH the regular full reimbursement day rate. To me, MS has a staggering # of THV days.
but further west in Louisiana….
LA: 7 hospital bed hold days done as a “leave of absence” and paid at 75% of the reimbursement day rate. THV 15 days reimbursed at 90%
and further westward….
TX: seems to be non-therapeutic recipient absences to an hospital are considered a discharge. This to me is pretty scary restrictive. So family needs to find out exactly if the NH considers a run to the ER/ED or an observational hospital stay to fall under therapeutic and if not what the NH wants to get paid to do a bed hold and be fully prepared to private pay to ensure their elder can return to the old NH. But in TX for THV, allowed to leave if the THV does not exceed 3 days. & reimbursement is paid for those days as if the resident was there with no fixed max # of days that can be THV. So in theory, a resident could go visit with family every weekend for THV.
For my mom, I did THV for her to go with me for a Saturday wedding in another county abt a 3 hr drive away. Me in my car, hubs & kiddo in another. And mom had been to these family members homes before and several times. Mom did get a note from the NH MD that she was fine to leave (Requested at her care plan meeting) and I got her meds from the floor nurse. What was really emphasized by the DON of the NH was that mom could not be picked up before 10AM on Fri and I had to have her back for Sunday dinner. The NH - like schools - have to do a daily census that is reported to the State in order to be reimbursed, aka “butts in beds” “butts in seats”. Fwiw on retrospect doing this was not the smartest idea even though she was still at the time very social and very ambulatory…. the bathing and bathroom runs were stressful. Thank goodness cars have baby locks as every so often when we would stop at a light, she’d try to open her car door. Fun times!
Nursing homes, greedy and underhanded bloodsuckers that they all are, saw an opportunity to possibly shakedown your mother and her family for more money that they aren't owed.
Don't pay them a cent for the days she was in the hospital because they were already paid.
If they insist on being paid for the empty bed, request a statement of payment from Medicare and Medicaid before you pay anything. This will be proof that the nursing home got paid. Show it to them if they continue with their shameless shakedown.
I used to do this all the time when my parent was in the nursing home if there were Medicare days left for the year. There were many hospital stays in a short period of time even when he became a permanent LTC resident on Medicaid. They still tried to shake us down to pay in cash to "hold" the bed because all the money wasn't gone yet.
They never got a cent from me until I'd hear back in writing from Medicare and Medicaid showing what they paid. Every time there was a hospital stay, the nursing home also got paid by Medicare or Medicaid for the "bed".
Don't pay them anything until you've spoken to Medicare and Medicaid to see what they've paid. In my state if a person in a nursing home is in the hospital 3 days or more and they have days left on their Medicare, that pays for some days in the nursing home. Most states have some kind of policy like this with Medicare. Talk to Medicare and Medicaid. Get statements in writing before you start writing checks for something your mother may not even owe.
If someone is not permanently in a nursing home, they are relentless and determined to keep them until every cent has been handed over.
You can never trust the people who run these places. Families have to be extra careful about every bill they are submitted because the LTC are never honest.
No, not necessarily. In all likelihood Medicare and/or Medicaid already paid for the bed space when the mother was in the hospital.
It's easy enough to check and to get written proof of.
What entitles the nursing home to be paid twice and double for the same bed space? Nothing. Never pay these people a cent until you see what other sources have paid first.