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Nursing homes, greedy and underhanded bloodsuckers that they all are, saw an opportunity to possibly shakedown your mother and her family for more money that they aren't owed.
Don't pay them a cent for the days she was in the hospital because they were already paid.
If they insist on being paid for the empty bed, request a statement of payment from Medicare and Medicaid before you pay anything. This will be proof that the nursing home got paid. Show it to them if they continue with their shameless shakedown.
I used to do this all the time when my parent was in the nursing home if there were Medicare days left for the year. There were many hospital stays in a short period of time even when he became a permanent LTC resident on Medicaid. They still tried to shake us down to pay in cash to "hold" the bed because all the money wasn't gone yet.
They never got a cent from me until I'd hear back in writing from Medicare and Medicaid showing what they paid. Every time there was a hospital stay, the nursing home also got paid by Medicare or Medicaid for the "bed".
Don't pay them anything until you've spoken to Medicare and Medicaid to see what they've paid. In my state if a person in a nursing home is in the hospital 3 days or more and they have days left on their Medicare, that pays for some days in the nursing home. Most states have some kind of policy like this with Medicare. Talk to Medicare and Medicaid. Get statements in writing before you start writing checks for something your mother may not even owe.
If someone is not permanently in a nursing home, they are relentless and determined to keep them until every cent has been handed over.
You can never trust the people who run these places. Families have to be extra careful about every bill they are submitted because the LTC are never honest.
No, not necessarily. In all likelihood Medicare and/or Medicaid already paid for the bed space when the mother was in the hospital.
It's easy enough to check and to get written proof of.
What entitles the nursing home to be paid twice and double for the same bed space? Nothing. Never pay these people a cent until you see what other sources have paid first.
For the NH/SNF, it will be dependent on how your States LTC Medicaid program administers its “bed hold” policy. What States do is breakdown “bed hold” into 2 categories: 1. Therapeutic Home Visits (which of course has an acronym….THV) and has a Physician approval requirement in the process. MD does not have to allow a THV.
and
2. Discharge to hospitalization w/usually a fixed # of days allowed.
Just what your State does is beyond mucho importante in all this.
For example, 3 States MS, LA & TX:
MS: 15 days bed hold per hospitalization and per hospital visit. Beyond the 15 is considered discharged from the NH. THV is a max of 52 days plus Thanksgiving and Christmas 3 day wraparound so a max of 58 THV days. MS pays NH the regular full reimbursement day rate. To me, MS has a staggering # of THV days.
but further west in Louisiana….
LA: 7 hospital bed hold days done as a “leave of absence” and paid at 75% of the reimbursement day rate. THV 15 days reimbursed at 90%
and further westward….
TX: seems to be non-therapeutic recipient absences to an hospital are considered a discharge. This to me is pretty scary restrictive. So family needs to find out exactly if the NH considers a run to the ER/ED or an observational hospital stay to fall under therapeutic and if not what the NH wants to get paid to do a bed hold and be fully prepared to private pay to ensure their elder can return to the old NH. But in TX for THV, allowed to leave if the THV does not exceed 3 days. & reimbursement is paid for those days as if the resident was there with no fixed max # of days that can be THV. So in theory, a resident could go visit with family every weekend for THV.
For my mom, I did THV for her to go with me for a Saturday wedding in another county abt a 3 hr drive away. Me in my car, hubs & kiddo in another. And mom had been to these family members homes before and several times. Mom did get a note from the NH MD that she was fine to leave (Requested at her care plan meeting) and I got her meds from the floor nurse. What was really emphasized by the DON of the NH was that mom could not be picked up before 10AM on Fri and I had to have her back for Sunday dinner. The NH - like schools - have to do a daily census that is reported to the State in order to be reimbursed, aka “butts in beds” “butts in seats”. Fwiw on retrospect doing this was not the smartest idea even though she was still at the time very social and very ambulatory…. the bathing and bathroom runs were stressful. Thank goodness cars have baby locks as every so often when we would stop at a light, she’d try to open her car door. Fun times!
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