Billing dispute with nursing home

[BK911]

So dementia mom lives with me.
She got pneumonia a while back and fell, and had to be admitted into a rehab facility.
After a few weeks the facility called and said rehab was over and we would have to start paying for long term care, or appeal the decision.
During the appeal the care would stay as was.
I didn't want my mom there and went to pick her up.
They would not release her to us for some unknown reason.
So I filed an appeal while waiting for her release.
This was on a Thurs and we didn't get the rejection notice until Monday.
We called the center and told them we were coming to get my mom.
All went well until I got a bill for over $3k.
I am trying to appeal but insurance said they were never billed, and the center is not budging.

What are my options?

[Zeke]

I think all states are supposed to have a SHIPS office since insurance is a state by state business. A quick search of SHIPS and TN should get you to them. They are neutral AFAIK. They should be.

I found yours: TN SHIP. State Health Insurance Assistance Program

[Baz]

"They would not release her to us for some unknown reason.
So I filed an appeal while waiting for her release."

If this is all documented......seems to me you will eventually be absolved of all expenses.

In no way am I an authority on the subject so just offering an opinion.

Sorry to hear of the aggravation on top of all the stress I know you must be going through, BK. If it means anything at all, I admire and respect you for looking after Mom!

Please give her a big hug from us!

[Zeke]

I've read similar stories before. Like Baz, I'm no attorney or expert, but the idea of not releasing a person does ring of false imprisonment. Is it reasonable to think that anyone can detain a person against the will of others who have authority such as power of attorney outside the realm of law enforcement?

Not to mention running up the bill while this is ongoing.

[BK911]

Thanks guys.
Dementia is tough to watch.
PSA, some think too much sugar is a leading cause.
I quit cold after seeing how fast Mom lost it.

Messages and emails to tn ship and ombudsman.
Fingers crossed!

We just switched over to hospice care.
Mom gets 5 nights every 90 days in a facility to give us a break.
No facility will take her until we resolve the outstanding balance.

Was really looking forward to our vacation next week during kids fall break.
Would have been the first in over 2 years.

[Zeke]

"Dementia is tough to watch."

Tell me about it.

[Dixie]

Originally Posted by Zeke

"Dementia is tough to watch."

Tell me about it.

Amen

[dad911]

Can you bring in an aid and save the vacation?

Have been through this recently with my mother and my father in law, you need some time to decompress.

The only vacations I regretted were the ones I cancelled or didn't go on.

[BK911]

We found another facility not affiliated with the original home.
We're going on vacation!!

[unclebilly]

Sorry you have to live this.

Dementia is a cruel, cruel *****e.

Dad refused to keep his sugars under control. Living with his blood sugar levels in the mid to high 20s accelerated the onset of dementia.

[cabmandone]

Doesn't Medicare cover 90 days in a rehab facility? I see! They said she was done with rehab. As far as not releasing her, that's not their decision. If she's done with rehab, she's healthy enough to return to at home care, that's the purpose of rehab in this situation. They don't dictate the stay, you do. They just give you release papers that state she's either being transferred to another care facility or to at home care. Any discussion with the nursing home regarding release should be documented. If they refuse to release, make sure that kind of stuff is in writing from your request to release to at home or another facility, to their refusal.

[BK911]

Yup, 90 days rehab is what they told us.
Then after mom was there they said 90 days or discretion of rehab administrator.
They old bait and switch.

Not real worried now since we found the other facility, but still want to get it cleared up.
Already moved most of mom's estate out of her name.
Couple more things to do but should be good by end of the month.

[cabmandone]

Originally Posted by BK911

Yup, 90 days rehab is what they told us.
Then after mom was there they said 90 days or discretion of rehab administrator.
They old bait and switch.

Not real worried now since we found the other facility, but still want to get it cleared up.
Already moved most of mom's estate out of her name.
Couple more things to do but should be good by end of the month.

They probably moved her to the "skilled" nursing home care which, if out of pocket, pays better than the medicare coverage for rehab. Either way, if you request her discharge, and you have the legal power to request that discharge, they can't hold her unless there is credible evidence of abuse. There are a couple ways to get discharged from rehab. If she meets the goals of the care team and if she refuses care enough times that she is discharged. Medicare won't pay if her chart notes she refused care.

[wdfifteen]

Originally Posted by BK911

Thanks guys.
Dementia is tough to watch.
PSA, some think too much sugar is a leading cause.
I quit cold after seeing how fast Mom lost it.

My dad had dementia and lived a healthy lifestyle, walked daily, ate well. I wouldn't call him a health "nut" but he was health conscious to the point where he ground his own wheat to make bread.

My mom lived on whatever junk food was easy. She outlived dad and had no memory issues whatsoever, which helped her maintain her unpleasant nature to the very end.

Originally Posted by BK911

We just switched over to hospice care.

That's hard. But, after 10 years of Dad's dementia, it was almost a relief when his body finally gave out. I'm pretty sure if he had lived Mom's lifestyle, his body would have given out sooner.

Originally Posted by BK911

Mom gets 5 nights every 90 days in a facility to give us a break.

What a blessing that is. It's not much, but even a little bit of relief from the pressure helps.

I understand your situation and I know it's extremely difficult. Good luck.

[Alan A]

How can anyone refuse to render a person to their relatives on demand?

Is that not a textbook definition of kidnapping?