What can be done about the 20 day rehab being paid to the wrong Nursing Home?

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2 rehabs were involved, medicare paid out of sequence.My Mom had to stay in a facility while awaiting swelling to go down in her broken leg before surgery. The facility was across state lines due to location. She spent most of her 20 days in this facility but had to be moved back across state line because of medicaid. She is now out of rehab after 60 days in last facility. !st facility said medicare sent 2nd facility 100% pay instead of 1st fac receiving it. Now 1st fac wants her to pay $1040 to them because they did not get their bill into medicare 1st. It is not my Mom's fault-we did everything by the book and kept up with the days to make sure she did not go over the days while in 1st facility. Does she have to pay for a mistake by the nh? What happens if she does not have the money to pay?

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Expert Answer
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I'd contact the ombudsman for the nursing home. Go to ltcombudsman.org and type in the nursing home's Zip code. That person may be able to help you straighten out this mess. Good luck,
Go online to CMS to see what your mom's payment history is. Get a cup of coffee because every item from physical therapy time and codes to daily room & board will be detailed and it could take a while to scroll through. Searching by date seems to be easier to maneuver through.
CMS is Center for Medicare and Medicaid
www.cms.gov or 1 800- 633-4227.
I work for a NH and I agree with both of the above statements, however you should also ask the 2nd NH why they would have billed for days that she was not in their facility. Ask if they intend to send they money on to the correct facility or are they going to return it to CMS. Then talk with the ombudsman about it.

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