My Dad had 5 surgeries/hospital stays and 4 SNF over 5 months. When he registered at the last SNF, I asked twice for them to verify coverage. After Medicare denied payment, they called me. Who is responsible for payment of the services they provided?
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.
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.
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.
What is an SNF? What is CMS?