Why bother paying your nursing home bill?


By elliemae   Follow   Thu, 9 Jun 2011, 8:29pm   1,901 views   8 comments
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According to CFR Admission, transfer and discharge rights. 42 Code of Federal Regulations ยง 483.12(d):

A nursing home may discharge a patient only if the discharge or transfer won't be harmful to the patient (isn't medically contraindicated). Nursing homes can only discharge a patient for the following reasons - the patient required medical care that can't be provided there (or the patient no longer requires a nursing home level of care), the health & safety of other residents is jeopardized by the patient remaining there, non-payment of the bill, or if the nursing home ceases operations. The nursing home is required to give a minimum of a 30-day notice to the patient, his family and/or guardian (responsible party) that contains the following:

1) The date of the proposed discharge
2) The reason for the proposed discharge
3) The state agency contact information that oversees nursing homes
4) The state ombudsman, if different from the above agency
5) The location that the nursing home proposes to send you to
6) The procedure as to how to appeal the notice.

If the notice doesn't include all of that information, along with any additional information required by that state, the notice isn't legal and can't be enforced. If the patient appeals the notice, it'll drag the process out a few months. Even if the patient loses the appeal, if he refuses to go to the place that the nursing home proposes to discharge him to, there's nothing that the nursing home can do.

They can't make you leave. It's nearly impossible. They rarely can force someone to pay - especially if they can't get ahold of the patient's money, like if a family member took it, it's doubtful they can do anything. They can threaten, turn you into collections, etc but they can't dump the patient out on the streets and they can't make a family member pay for a patient. If the patient refuses to pay, there's nothing that the nursing home can do.

I can't tell you how many stories I've heard in this recession - children keeping mom's money while mom remains in a nursing home. I can tell you that I've yet to see a nursing home successfully collect on a bill. It's amazing.

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  1. Done!


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    1   8:26pm Wed 15 Jun 2011   Share   Quote   Permalink   Like (2)   Dislike (1)  

    Yeah more the reason to sweat and toil over your golden years while your young contributing to your 401K that either may or not be worthless when you need it. Let alone next month.

    We can spend trillions in wars lose 7 billion unaccounted for in Iraq the interim government stole, spend untold more money on bombing countries we don't even have a formal declaration of war with. YET, we refuse to ponder a Government we entrust to provide basic needs for the sick and the elderly when private enterprise would rather dump them on the street.

    You know Ellie my heart bleeds purple Piss for those for profit nursing homes, really. If they weren't there then we'd have provided a real solution by now.

    You know in Asia, the eldest sibling is expected to provide for their elder parents. We're to Goddamn greedy for that.

    But don't sit there try to make me feel sorry for the Medical establishment because Ruth Rosencrant kids are money grubbing bastards, and wont hand over Ruth's life savings to the company store.

    Good for them, I say.

  2. elliemae


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    2   10:18pm Wed 15 Jun 2011   Share   Quote   Permalink   Like (1)   Dislike (1)  

    Oh, bass.

    Please show me where in the post I defend the nursing homes. Please show me where in the post I even suggest you should feel sorry for the medical establishment.

    You are so quick to decide what side of an issue someone is on, and then attack them. Obviously you believe that nursing homes are a bad solution to the caregiving needs of the elderly.

    Nursing homes aren't state-run for the most part. The owners want to make money, and that's fine for them. They still have to follow the rules. It's a way to make money that's more honorable than wall street, and they're much more highly regulated.

  3. Pam


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    3   9:38am Tue 21 Jun 2011   Share   Quote   Permalink   Like (2)   Dislike (1)  

    When my mother had to be discharged from the hospital into a nursing home for rehab, the nursing home wouldn't take her unless I signed a paper saying I would be personally responsible for the bill if she couldn't pay. So, wouldn't they have been able to come after my assets if we hadn't paid??

    Medicare was supposed to pay for up to six months, but they will only pay if the patient is making progress on rehab. The nursing home overmedicated my mother to the extent that she pretty much became a vegetable and stopped making progress on rehab, which stopped Medicare coverage. The bill for the first six weeks after Medicare stopped paying was over $10,000.

    When I was finally able to buy a house where I could take care of her in my home, I stopped all the unecessary narcotics and she became able to function again--although never at the level she was at when she entered the nursing home. As far as I am concerned, they robbed us of what quality of life she had left, as well as our money.

  4. elliemae


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    4   10:23pm Tue 21 Jun 2011   Share   Quote   Permalink   Like   Dislike (1)  

    Pam:
    I'm so sorry for your experience. No, they wouldn't have been able to come after your assets. They simply don't tell you that. And they couldn't have evicted her without going thru the process - and then they still can't make her leave.

    Medicare does pay up to 100 days, but you're correct in that they only pay if the patient is progressing. There were things that you could have done to stop them from over-prescribing meds, but they don't tell you that.

    That's why I wrote the Nursing Home Survival Guide. Some nursing homes provide quality care without having to crawl down their throat - but if you must there are state agencies to help you along with laws & rules they have to follow.

    Any money your mother owed should have come from her finances and only hers. They can't make you responsible for her bills.

  5. RealTruth


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    5   7:25am Fri 25 Jan 2013   Share   Quote   Permalink   Like (2)   Dislike  

    My Dad was in a discharge from a nursing home in NH for non payment. I am his DPOA HC, NOT his POA. Just got served by a sheriff being sued along with my Dad as his POA and stating I signed the Admission Agreement of which I did not. I signed the responsible party which means if he did get discharged, I would take him back. That was before they broke his second hip. He was also drugged to the max on Haldol and Risperadol! Finally at a new nursing home and off all drugs. We actually can communicate somewhat. They ruined 1+ years of quality we could have had with him. This is a large amount of money they want that I do not have. He does not have it either. Again...sleepless nights!

  6. elliemae


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    6   11:10pm Fri 25 Jan 2013   Share   Quote   Permalink   Like   Dislike (1)  

    Realtruth:

    find yourself an attorney who specializes in nursing homes; he/she will review all the documents and also request medical records for a malpractice countersuit if what you say about their care is true. You were served in a civil lawsuit and you need an attorney.

    The nursing home corp is hoping you'll get freaked out and pay the bill.

  7. curious2


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    7   11:32pm Fri 25 Jan 2013   Share   Quote   Permalink   Like (2)   Dislike  

    Are there any data comparing the life expectancy of nursing home patients who run out of money and go onto Medicaid or don't pay vs patients whose survival is more lucrative?

  8. elliemae


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    8   1:59pm Sat 26 Jan 2013   Share   Quote   Permalink   Like (1)   Dislike (1)  

    curious2 says

    Are there any data comparing the life expectancy of nursing home patients who run out of money and go onto Medicaid or don't pay vs patients whose survival is more lucrative?

    I haven't seen any - but I haven't looked, either.

    Patients who pay privately and those who are one Medicaid are (supposed to) receive the same care. But I'm sure that there are people who are strongly encouraged to allow a family member to die if their care is too costly.

    A private-pay patient whose nutrition is provided via g-tube can cost $10,000 to $15,000 per month. The same patient, on Medicaid, has his costs absorbed by the nursing home. Medicaid doesn't pay more, nor does the patient.

    Patients whose costs will be prohibitive are often encouraged to go on hospice, not because it's what they want but because the hospital or other facility will save money.

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