My mother-in-law has been in a nursing home for about a month. She was in skilled nursing for two weeks and was then diagnosed (misdiagnosed) with renal failure. My sister-in-law, how has power of attorney, switched her to hospice care at that time. Two weeks later, the lab was repeated (long story, but my doctor brother-in-law requested this - then a week and a half later it wasn't done so several family members complained), and it turned out she's not in renal failure (the initial lab was done while she had a stomach bug with vomiting and diarrhea). So my SIL switched her back to skilled nursing - she'd been having physical therapy in skilled nursing but that was stopped with hospice. MIL has mobility issues due to severe arthritis, but physical therapy allows her to get out of bed. While in hospice, she was given meals, meds three times a day, and helped to the bathroom. Other than that, she laid in her bed all day.
Now my SIL says she's gotten a bill from the nursing home for room and board for the two weeks she was in hospice - ?? Her insurance (commercial primary with Champva secondary) pays for the skilled nursing at 100%, hospice is covered, but NH says "medical insurance doesn't pay for room and board,"
Is that correct? The nursing home never told us she'd be billed in hospice (whereas no bill in skilled nursing), hospice didn't talk to us about it, and nobody told us she could go home - we all didn't think she was capable. I understand that long-term care insurance is what you need for a nursing home stay, but I guess I don't understand how this whole hospice thing works. She decides to forego expensive medical care, opting for comfort care - that should make insurance happy, right? Now we're being told "thanks - now insurance pays zero!"
Is the nursing home billing wrong? Can we appeal? Any insight or suggestions?