Can I sue the nursing home after they refused to lower my mom's bill?

I have found with "some" homes, the owners are willing to work with family in regards to financial consideration. I don't think you stated that you had discussed with the home regarding financial consideration. That being said, your approach to them is utmost important. If you are interested only making the home suffer as some sort of punishment, that would not go over very well. However if you have incurred additional medical expenses while in the home as a result of injury during that stay and created a financial burden you are having difficulty with, you may find they will work with you from that standpoint. Good luck..

They should have informed him that beyond the 100% medicare-paid 21 days, he would owe so much per day from day 21-100 or until her maximum out-of-pocket is reached. My mom owed $100/day after the 21 days through her medicare-advantage plan (HMO), so as of the 1st of January she will be covered under a Medicare Supplement plan (Medi-gap), which will eliminate those co-pays completely. Your dad might want to check into that option.

Thanks for these helpful comments. Yes, it's true, my mom fell at home resulting in her first hip fracture and stay in the nursing home in the first place. So I really can't say she fell because of their negligence, she fell despite being there. And, she was only in the hospital for the second fracture 24 hours for observation, and that was because I was there saying we were not consenting to any further surgery, anyway. The facility she was at, I thought, was excellent, but if they have to go back to one, there is another very good one in their area so I suppose we'd give them a shot. We're not litigious people so have decided not to sue. My dad then asked me to write thankyou notes to the caregivers at the facility that he liked...so it can't be that bad of a place. I think he's just mad about what he owes which we were informed about upon admission. He's just mad at his circumstances, misdirected at the staff/nursing home.

My MIL recovered from abdominal surgery in the NH section of an excellent continuing care community, on which she already put a deposit. When she was discharged, she entered the "memory support " section of the assisted living portion of the same community. Long story short, she fell twice while in the NH-- once while she attempted to climb/crawl over the railing of her bed, and another when she did not call for help, or use her walker, and attempted to walk to the bathroom by herself. Both times her roommate cautioned against these actions (mil told her to "mind her own business") then immediately rang the emergency bell. Too late, mil was already on the floor, but unhurt. I agree with tommybs, that the anesthesia after surgery affects their judgement, esp. in the elderly (we were told this by nurses and her MD) and mil was already diagnosed with mild dementia. We do not blame the NH, and the only way to have prevented this was to have a private duty nurse 24 hrs/day. It may be difficult to prove negligence in such a situation, and you would have to prove that your mother was not contributory to the negligence.

Short of negligence or lack of staffing, as reguired by state regs, per resident, pursuing a law suit is a waste of time, effort and money spent. The only way a LTC facility or resident can be assured of no injuries such as from falling would be to have one on one staffing. I doubt that anyone can afford that. Working within the rules and regs set by the feds and states on LTC facilities, such as no restraints, unfortunately things, bad things can happen. There are good reasons for most regulations. Keep in mind these homes are there for two purposes, primarly to make money for the owners, secondary is provide a service so they can collect money. It is a business not charity.

I just remembered something! When my mom overstayed by 30 days at the beginning of the year, the nursing home only charged her $2500 - by hitting that amount they said she had reached her insurance's out of pocket expense limit for the year and they couldn't charge her beyond that. Check into that!

Your poor Dad, $8,000 is insane. I hear of people falling in NH's all the time, it makes me sick that they are so short staffed and careless. I brought my Mother home to recover from her broken hip and didnt take an eye off her for a second, even slept on the floor next to her for weeks until she could put pressure on it again. I do hope your Dad can sue, or get medical coverage for another "incident" happening. I feel for him, very much, and your Moms situation and wish you the best of luck.

Sometimes after a mayor surgery that person may have some issues with forgetfulness they may still think they can walk by themselves if dementia is present then really the only thing you can do is move them ,but you must remember in order to feel comfortable you need one on one care so they can be watched at all times that will be very hard there are times in a blink of an eye they can fall

Question: When your mom fell & broke her other hip, did that result in a trip to the hospital? If it did, then those days she was gone from the nursing home DO NOT COUNT against her 100-day coverage at the nursing home. Beyond that, I don't have any advice other than the excellent advice already given.

In this country anybody can sue anybody else for any reason, so the answer to "can I?" is always yes. The real question is, Is it a good idea? Even if the error is someone else's, make sure you don't end up paying more to pursue the case than the problem cost you in the first place. So first and foremost, MAKE SURE you do NOT agree to pay a lawyer outright, but ONLY "on contingency" meaning they collect only if you win. Second, understand something: if you're mad because the NH won't agree to lower the bill, you have to recognize that they would be completely foolish to lower the bill on the grounds that it was their fault in any way -- doing so would mean that, if someone hit them with a much bigger lawsuit blaming them for all the consequences of the fall, negligence etc. they would already have essentially accepted responsibility. And it would probably not stand up in court anyway: your father is claiming that "she fell on their watch, which CONTRIBUTED to extending her stay." I capitalized "contributed" because he's saying that she would not have stayed so long if it hadn't happened while she was there. You'd have to prove either (a) that she would not have fallen or (b) that her fall was worse than it would have been if she had been somewhere else. In other words, gross negligence. Can you prove that? The fact that she already broke her other hip BEFORE she got there means she was frail. Does she have osteoporosis, for example? It happened WHILE she was there. You'd have to demonstrate that it happened BECAUSE she was there.

Best bet is actually talk to a good lawyer. They are hesitant to take a case unless they have a good chance of winning, so they are usually pretty truthful if you will win or not. If not, your dad can do what I did for my mom. They miscalculated her Medicare days and then tried to charge mom for the balance. I told them it was their fault for miscalculating. When they still refused, I paid them $50 a month on a $5000 bill. Sometimes I would only pay them $20. But I happily wrote a check every month. As long as they accept the check and cash it, they can not sue YOU for nonpayment. And the paperwork for them on those small amounts must have been a real pain. My mom passed away a few years later, and after the notice to debtors went into the paper, I stopped paying. She still owed them about $4000. It was my own personal feeling, but I just didn't think it was right for her to pay her hard earned money for their error!

@sak9 Many tort lawyers only take a case with an excellent possibility of winning, because they only charge a percentage of the judgement. If they don't win, they get nothing.

The only one to benefit is the attorney. Consider moving your mother to another facility.

quotw Hiker: "your dad would need to be able to prove negligence by the NH."

If your dad is able to do this, then you reserve the right to sue.

Do you or your dad have copies of the paperwork that was signed when your mom was admitted to the NH? There is probably language in there that covers this issue.

In my mom's "Business Contract" with the NH there is a paragraph that reads "The HRC shall in no way be liable for injuries of any kind suffered by the resident while under its care.........., except where injury is caused by the negligence of the HRC or its officers, employees or agents."

If your documents have similar language, your dad would need to be able to prove negligence by the NH.