Nursing home keeps sending me bills for the last 4 days in their facility. When I contacted them they keep saying medicaid will not pay until patient liability is paid. Her last social security check went towards her burial out of state. They keep billing $1,208 for her last four days when her total monthly bills were paid at $1,449 every month for 3 years. My mother stopped eating and talking 2 weeks before she died. She had Alzheimer's. All hospice claims have been paid by Medicare. Do I need to get an attorney?
It is a debt of your mom’s estate.
You were your moms POA and that stopped cold when mom died. So as of moms DOD last March 2022, you have no authority over her legal and financial. As mom is dead any bills become debts of her estate and so move into the world of probate. Only if you are the named Executor for her estate and have Letters Testamentary from the court showing that this authority over her Estate is in place that you can act on those debts. That hasn’t happened and probably won’t happen…… HOWEVER States allow for a period of time for probate to be opened, a period of time for families to mull over if they even want to open probate. Could be years and this is mucho importante! (((For example TX is 4 years, so family / heirs have a 4 year window to decide IF probate will even be done.))) So because of this “window”, you can do a quick 2 paragraph letter to the NH stating the attached bill is not your debt but is a debt of your mom’s Estate (put in her name & DoD) & as per the laws of State if Whatever, family & or heirs have x period to open probate…. and that you anticipate that probate will be opened within that time frame and so the (name of NH) will need to file their bill as a debt against the Estate as per the Notice to Creditors according to the State of Whatever for their administrative code for probate.
Imo you want to sent it certified with that green post card (the registered receipt) as it comes back to you with a date and a signature so it’s legal. That they have been notified it’s not your debt. The NH will likely turn it over to collections (sigh) and you want to be able to send a xerox of the letter and that green card to whatever debt collection outfits start contacting you. They are relentless and ruthless.
Now mistakes were made as moms required by Medicaid copay to the NH from her SSA should have been paid for her last 4 days there. Someone dropped the ball on this part. But absolutely no frickin’ way 4 days were $1203.
NH # are off. LTC Medicaid - in my experience- pays in real time. Which means pay a day rate unique to each states LTC Medicaid program.
To figure the bill out, it’s 2 intersecting math problems:
say your State LTC pays $185.00 per day.
Mom lived for 4 days into the new month 4 x 185.00 = $ 740.00
Medicaid would pay NH $740.00 that’s it.
AND
your mom got from SSA of $1200 a month. ($1200 is national avg)
March is a 31 day mo, so $38.71 per day copay from SSA $
4 days in March @ $ 38.71 = $ 154.84
in this math problem resident liability $ 154.84. At the very most!
Not $740.
((Note: it’s actually even less as there was that personal needs allowance she was able to keep from her SSA income ea month.))
Only the set by the State copay (based on income) is her liability.
There may be attempts by the NH, local attorney and 2-4 debt collection groups over next year or so. “Not your debt” needs to become your mantra 🕉 . They all get a letter. It will go away.
So, if that check u used for her burial was the check she received in March, that money would have been due to the NH if she had not passed. Mom is probably being charged day fees for the first 4 days of the month. Because Mom lived the first 4 days of the month, your Mom owes those 4 days. IMO the $1208 is owed.
If you are being billed full day fees, that I may question since Hospice was in there supplying Depends, wipes, chucks, medications, an aide...so you may not need to pay the full amt. And they kept the supplies left over.
You need to read the contract between Mom and the NH to see how it works when someone passes this early in the month. It may just be like renting an apt, you live there first 5 days into a month, you pay the full month rent, or at least the 5 days are prorated.
Hospice done in facilities only pays for the care, not room and board. That is still paid by the resident. What the Hospice got paid has nothing to do with the 4 days being billed for the room. IMO this is owed. If Mom had lived longer in March, the OP probably would have sent the check received in March to the NH. I would bet in this instance, that Moms check comes later in the month but it still needs to cover for the first 4 days of the month she was alive.
I think there is confusion here on what Medicare pays for Hospice care and the payment responsibilities of the resident on Medicaid. This is an assumption on my part...seems Medicaid won't pay because Moms share of her care, would offset the amount due. Mom is responsible for her share of care then Medicaid steps in with their share. Maybe its residents share paid first, Medicaid receives proof that the amount has been paid, then they pay their share. The resident must always pay their share.
I don't think a lawyer is needed, which will cost you more than amount owed. I don't think there is any fraud. I just think its misunderstood how the process works. What you need to do is sit down with the finance dept at the NH. Erase your brain of what you think it should be and listen to how it actually works.
If the OP had paid March and Mom died later in the month, the OP would have owed on the funeral. Because, there would be no April payment since Mom died in March. OP would owe either way.
I am sorry for the loss of your mother this past spring and I hope that your memories of the good years bring you comfort. She now has a whole new body of light, free of her aged physical body's limitations. She's whole again. You're facing some firsts without her: First Christmas; I've found those firsts to be among the hardest.
As to the NH sending you bills: this is an illegal practice. Any facility receives an agreed-upon amount for the fee for service residents and they are contractually obligated with the state to accept this end of life lack of payment. DO NOT ever for a moment think that you have any financial liability.
Call the state Medicaid services - or local - and report this illegal billing practice, that will stop the NH from sending you any more bills. If you wish, you can call the NH billing department and provide them with the address of the Medicaid Complaints office that is listed on the admission paperwork provided to your family and posted everywhere in the facility (also easily found online), and tell them you've forwarded the bill to them and tell them to send any further billing there.
Don't waste a thin dime on an attorney, you have well-established law on your side and once you do your individual complaint, they'll look into the facility billing practices. It's likely that you'll be helping other out as well.
This is a duplicate from Oct 2022.
Thanks for the catch! I so despise being trolled in this forum, it's disgustingly rude and so very ill of people to do this!
I know it’s frightening and bothersome to get these notices, but you do not owe anything. Like others have said, give them the address of the Medicaid office or the cemetery.
Very sorry for your mother's loss. Contact the county where your mother resided. Attorney looks necessary.
JoAnn29 kindly caught and posted below that this is a duplicate post from Oct, 2022. We are being trolled by this profile! Pls see below.
https://www.agingcare.com/questions/my-mother-passed-away-march-5th-in-the-nursing-home-she-was-in-for-3-years--i-was-her-poa-as-my-moth-477664.htm
This is a duplicate from Oct 2022.
Have they ever credited the per diem payment you sent?
See All Answers