My mom has been in NH for rehab after a fall since mid-June after a hospital stay. The first 2-1/2 weeks were covered 100% by Medicare but she was discharged from Medicare coverage eff. 6/28 at which point it turned over to Medicaid coverage. Her determination letter from DHS clearly states that effective 7/1/19 she has a patient pay amount of $701.00 per month.

The nursing home was sending the initial invoice to my mom at her home address (even though she's THERE at the nursing home), and I'm picking up her mail at the P.O. every couple weeks while it's being held. There was a redetermination made at the end of July which decreased her patient pay by about half, to $302/month, once again clearly stated in the DHS letter as being effective retroactive to July 1, 2019. It even specifically spells out that this patient pay is for the months of July, August, and September if my mom is still in the NH in September.

1. This latest billing from the NH was sent to ME at my home address. I know it's a technicality and I'm a co-owner on her checking account so I will be writing out the checks (from her account) to the NH anyway, but I don't want any insinuation that I am "responsible" for these mom is. I never signed anything stating that I personally was financially liable for her patient pay/nursing home charges. I just don't want the NH to come back later, after she has passed away, etc., saying that I personally owe them money, and that I didn't object to the invoices having my name on them in the past, etc. Am I being too paranoid about this?

2. The updated billing that was sent to ME at my home address listed the updated patient pay amount for JUNE, July and August. According to the DHS letter there was no patient pay for the month of June. But the NH is showing "June 29-30" with a patient pay as well as the full months of July and August so far. When I talked to the DHS person about having the redetermination done she even made the comment about how she's not having to pay for June even though the last 2 days in June were covered under Medicaid. Am I being petty about that extra month? That's $302 that could be used toward my mom's other household bills. The initial billing that the nursing home sent to my mom was for the month of JULY only for the first patient pay amount of $701. Not sure why they have now added June since June was never indicated in either determination by DHS.

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I shouldn't worry about the address. The mail is sent to you as your mother's representative, at such-and-such billing address. The billing address happens to be yours but it doesn't follow that you, resident at the same address, are liable for her bills. I think I would pull them up about the addressee, though, and require them to submit bills to your mother. "For the avoidance of doubt," if you will, but also as a common courtesy - your mother is not a dog or a piece of furniture, and her bills should be addressed to her.

Medicaid and DHS rules make my head swim, even after all this time, but all the same it seems unreasonable for the NH to demand a full month's payment for a two day overlap, especially as the DHS doesn't agree there even is an overlap. I like Lealonnie's idea of making them a proportionate offer.

And it is NEVER petty to fight for your mother's last cent.
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I think the same thing is going to happen to me. Mom had to stay a couple of days longer in rehab too.
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Your Moms on Medicaid and your are allowed to have money to pay her household bills?
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If her mom is in rehab then it may be community Medicaid that is footing the bill. Community Medicaid in some states pays for short term rehab. If that’s the case, that’s the reason she has a share of cost and all her income isn’t going to the nursing home.
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I do NOT think you should have to pay a full monthly fee of $302 for your mother's 2 day stay in June. Let the nursing home know you will NOT fork over $302 but instead $20.14 which is 2/30ths of the full monthly rate, which is MORE than fair. If that's not acceptable with them, then tell them you'll take the matter up with DHS who said you owe NOTHING for June, and you'll let them know the decision. It's not's important to do whatever is necessary to preserve your mom's money for her care, not for nursing homes to steal!

When my mother was in rehab for the 20 day period covered by Medicare, I had to keep her there for 4 extra days (long story) and pay out of pocket $1350 for the 'luxury'. Afterward, I received another bill for the medications she took during that 4 day period in the amount of $28.00 which I paid right away, then received ANOTHER 2 bills for the same amount, which I threw in the trash.

As far as your mom's bills being sent to you, I wouldn't worry about it. I've had my parents bills sent to me since 2014 when they were both placed in Assisted Living. When I started getting old bills for Dad's care AFTER he had passed away, I informed the senders that he was deceased. That stopped the bills from coming entirely. And, since Colorado is not a filial state, I am not responsible for my parent's financial care ANYWAY, so if bills come after my mother passes, they won't be paid. Sue me, or better yet, sue HER! :)

Best of luck!
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