FIL was in a NH post surgery for rehab therapy which Medicare was billed for. He was discharged to an ALF after a few weeks. He left NH at 3:30 pm and arrived at ALF at 5 pm. ALF is charging that as first day of billing since he was at the facility at midnight ("the counting time" set by DHSS). So if Medicare pays for the last day at NH (discharge date), do we as a private pay resident also pay for that day at the ALF? It seems like the day of discharge from one facility and admission to a different facility is being charged for twice. Am I confused? Thanks!
What MediCARE paid to the rehab/NH or the amount paid is of no concern to the AL.
It sounds like you are especially concerned on his financials, which I can understand. Out of curiosity, has your dad paid his 20% rehab copay? You mentioned he was in the NH rehab a few weeks..... if so, your dad should have a separate bill for his 20% copay due to the NH. I think it’s $189 a day if it’s Original MediCARE. If you or your dad hasn’t yet gotten a bill for copay yet, that’s not unusual. Often seems for a NH & rehab facility, if elder there for rehab beyond 20/21 days 100% paid by MediCARE, assumption is kinda made that they are likely not to return home but instead will stay in the facility and go from a rehab patient to a NH resident. So 20% copay kinda gets set aside till everybody has a better idea if they are returning home or staying. MediCARE pays lots way lots more than Medicaid so even at 80% it’s a nice amt NH is getting. So NH can wait to deal with the 20%. If your dad hasn’t gotten his copay bill, expect one. Unless he has really good secondary insurance that pays the full 20%.