After verifying coverage, the SNF my dad was in made a mistake and provided services 18 days after Medicare coverage expired. Who pays the bill?

I think the problem here was communication. The facility does not release a patient until a doctor signs off. The facility is responsible for finding out what Medicare and the suplimental will pay. Unless you stipulate you cannot afford to pay over the days covered, they will continue to care for the patient until doctor or rehab feel the patient has hit a plateau. Papers had to have been signed showing what the patient is responsible for. At the time my Mom was in rehab I told them I was not going to pay beyond the 20 days. It would have been$152 a day. Mom doesn't have it.

Unless the error is in writing, the patient picks up the bill.

The Finance department should have made you aware of what your father would have been responsible for. Are u talking about skilled nursing or rehab in a skilled nursing facility. Rehab Is only covered for 20 days fully. After that 50% up to 100 days after that patient is responsible. Not sure about short term stays in a skilled nursing. If ur Dad could not afford this, then Finance Dept should have helped with Medicaid. You, unless you signed you were responsible, are not responsible for payments. Your Dad could ask for a payment plan.

I don't have an answer because it is hard to understand what you are writing about.
What is an SNF? What is CMS?

When it comes to nursing homes which are very expensive, never leave coverage up to an individual who works at the facility. You call Medicare and get the coverage information yourself. As with government agencies the people who work there will make mistakes. I had Social Security okay my one-half benefit from my husband when I turned 66. I went into the office to file, I was sent a letter saying my benefit would be increased $200, so I traded our car for one my husband could get into and for one month all was well. Then a letter came denying my increase in benefits and I was to repay $712! I immediately called my office, explained what happened and got a waiver which let me off the hook. However, I then could not afford the vehicle, had it repossessed, the dealer auctioned it off and charged-off over $14000. I will have this negative reporting on my credit report for the next five years and have to constantly explain Social Security made the mistake. (I saved the letter which stated by them "they" made the mistake). Get your information in writing always!

Please note that timing is important both in appeals and in Medicare coverage periods, which restart after 60 days without use of Medicare. See www.medicare.gov.

Please also note that the new SNF rules treat returning from the hospital as returning from the hospital, not as a new admission which the SNF can deny.

Your dad.
If he has a secondary insurer, LTC policy or Medicaid, those could be filed for to see if any coverage. But if not, it is his debt. If you signed the admissions paperwork / contract, the debt is yours also unless it was signed as "Jane Smith Jones in her limited capacity as DPOA for John Jones".

Your dad needs to file an appeal of the denial. Usually CMS send out a statement with details on all events every 3 / 4 weeks & the appeal info is on the final page. Do the appeal (make copies) and mail it certified mail to CMS. You send a copy to the SNF. In theory while it's on appeal the debt is suspended. Basically an appeal buys dad time before dealing with the debt collection process or coming to an agreement as to how he / you are paying or it's found to be an error & Medicare pays the SNF.

So dad has a recurrent.... Is it C. Deff? C deff often has them on the revolving door in/out hospital & SNF. Optionally for medicare each hospitalization is a new event for Medicare coverage & a new discharge to a SNF for rehab. If so, this last one wasn't viewed that way. It could be correct as its a continuation of care or it could be a mistake. That's why you need the appeal done.

I had an old BFF who's dad was on the CDeff roller coaster & being outside of medicare coverage happened. Her bro was the DPOA & both he & her dad refused to pay, not my fault yada-yada....types. Dad owed SNFs, inhome care
providers, etc. What was bad was that the nearby SNFs started refusal to admit him post-hospitalization as they can find a reason to decline a post hospitalization referral. Ditto for in home care companies. She eventually took over & got dad eligible for medicaid, once on Medicaid coverage between Medicare medicaid was seamless. But old debts were still there & she worked out a payment plan from dads SS income. Dad or you or whomever is his DPOA want to try to get on doing an appeal and if unsuccessful getting debt worked out as it can morph into problems in placement later on. Plus the whole debt collections hounding.

Verification of coverage is typically the responsibility of the facility, so I would think it's entirely their obligation to either pay or challenge the issue. However, I think the timing is critical; when did they first advise you that coverage was in place, and when did they advise you that Medicare wouldn't cover?

It wouldn't hurt to call Medicare or document in writing that it was your understanding that coverage was in place. And assuming Medicare eventually bills you directly, be prepared to appeal.

So, document everything in preparation for an appeal.