ALF back charging for personal care. What do I do?
Just got a bill for $10,000, never notified or discussed. ALF recently changed ownership. No new contract. Mom's status hasn't changed. I have a meeting with them tomorrow. I am livid. Mom's been there for 4 years. Advice?
Our ALF contract says (paraphrasing) " if we think your parent needs an aide at night so he doesn't wander to another floor, we will hire one and charge you, we don't have to tell you until after the fact." So, read your contracts carefully!
Garden that is exactly how I feel. It is really the stupid stuff. AL section of facility had cable TV. My uncles only pleasure was watching the ball games. I asked how to go about getting him cable and they told me it was not possible in the SNF. I called Comcast and they told me the whole place is already wired and all I needed was a different box. I was so annoyed that I didn't even tell them I did it. I was in the room when the cable guy came, switched boxes and the bill was sent to my home. I really don't even know if they did it. This was years ago and I was paying about $5,000.00 a month to share a room. It really is exploitation when you think about the size of the room and that the only time he had interaction with the nurse was to give him his meds. Everything else was done by an aid.
Patrice, it's this kind of overcharging and exploitation that I find really offensive. Sometimes it seems as if you're battling a group of people who are determined to exploit the patient, but they're not even the medical staff who are providing the real care.
I think one of the worst examples was $14.00 for a tube of chapstick (containing petrolatum) sold at grocery stores for about $2.00 (+/-) for someone on oxygen who can't use anything containing petrolatum.
In his room they still tried to make me pay because they opened the pack and no one else could use it. The place treated him well but I was really annoyed that each month the bill had mistakes. Some months it was less then $10.00 but it still annoyed me to no end.
When my uncle was in SNF as a private pay patient (he was in a financial position to pay the bill) i was amazed when I received the first bill. There were charges of $5.00 for soap and $5.00 for shampoo for each shower that he was supposedly given. I did not have soap and shampoo there. They charged for pull ups and a few other things. Nursing home doc changed his Meds and the next month i was charged for the old and new meds. Needless to say I bought him soap and shampoo . ironically they used the same one bottle for soap and shampoo and it cost him $5.00 a squirt. They charged him $50. For a bag of no name depends. When I complained because I had depends on ther
The only story I have to share is about the issue of hospital admission vs. observation - different type of facility, different issue. It was a situation of going the somewhat arduous route of challenging a Medicare decision vs. paying outrageous exorbitant charges by the hospital for medicine because of the "observational' classification.
Wonderful news! Give them credit for ethics and honesty, or whatever supported their admission of a mistake. Sounds like they're upstanding business people.
It's also reassuring to hear about a good organization; there are so many horror stories of ones that aren't.
And it's also especially helpful to know how a situation was resolved in case some of us find ourselves in a similar predicament.
Mystic, so glad you got this resolved to your satisfaction. This is a good example for all that conducting business in a business-like manner is the best way.
Well, I had to come back here and update. ALF admitted their mistake, there will be no back charges, but as I expected, there will be new charges going forward.
That's what I was hoping for, and I must say they were very good. I do like the facility and the care they give.
Hey! There are good places and good people out there! Just have your paperwork in order! :)
U[date: The meeting went very well. I went in with a smile and a please help me. Very empathetic, concerned, apologetic, cordial, etc.
Although nothing was resolved today, I did agree to pay the non-disputed amount and there will be no late fees or penalties on the remainder. Apparently something happened in the transition and there will be a thorough review as to what happened and why. There was no documentation that I was ever notified of anything.
They also listened to me as to what I'd like, which is that to pull $ out of my hat would create undue hardship and if there was a mistake of under billing that we should renegotiate going forward, not back and I seemed to get head-nods, but no promises. There will be another meeting next week.
Oh, and went armed with all my paperwork and invoices for the past year. They made copies.
Sandwich makes a good suggestion if they try to evict your mother. You could also call their bluff and make them back down by having the phone numbers to the local news stations with you, and advise that you think their position wouldn't reflect very positively on the organization if it's aired as a piece on the 6 pm news. Do you have a good "poker face?"
Wow, this really makes my blood boil. This is soooo nasty - egregious to be more appropriate.
Everyone's given you good advice, especially the documentation and the advice to stay calm, which I know is hard to do - when I've been in a similar situation, it's easy to become angry.
Sometimes thinking of this situation as doing it for a friend rather than your family helps to create enough distance that you can be more calm. Take yourself and your family out of the picture and pretend you're handling this as a representative for a friend.
And there's always the old adage, low class as it may be, to think of them sans clothing and they'll be less intimidating. And please excuse the rather vulgar nature of that suggestion, but it does work.
If there's anyone who can go with you, it won't be you vs. x number of them, and my experience is that typically there will be a lot of talking or nontalking, just staring faces all trying to intimidate you.
You know of course that if you don't know what to say, don't say anything. Just stare back at them, and let them squirm. Then you can reiterate that you need their documentation before you can discuss anything.
I would offer that you commit as well only to reviewing all the DETAILED, LINE ITEM charges that you expect them to provide. They may try to get you to commit to an agreement to pay; don't. Advise that you can't agree to anything until you've seen their alleged data and documentation. Shift the entire burden of action to them.
And please let us know how this turns out after tomorrow's meeting.
Good luck, keep your cool, and as the old saying goes "sock it to them!"
It always amazes me at the sneaky underhanded tricks the corporate finance office will turn a blind eye to when it helps the bottom line.
If they get pushy in the meeting and threaten to throw your mom out on the street, just quietly state that you know they can't do that legally. But if they do, call 911 and have them take mom to the hospital, NOT YOUR HOUSE. Then call Dept Human Serivces crisis hotline and make a complaint while you are still on the property.
Tell the facility that you will need an opportunity for legal review of the bill and the service approvals, and expect to follow the policy outlined in the lease/rental agreement for evictions, considering all other bills are up to date.
Before you meet with them, find that contract and read it carefully for instructions on how billing disputes are handled because there will be a timeline in there. They should have sent you formal notice by mail when any rate changes were made in the past. I get a letter when the beauty shop raises rates, so rate changes on add-on services would definitely have a notice sent out.
Make absolutely sure there weren't any past rate changes that you could have missed, that would have meant something is really now in arrears.
Jeanne, etal. thank you for your sage advice. I will be calm, cool, collected and business - like as I've always been. It's just been that I've always done and I'm just blindsided at this latest. I'd like to rant, but it certainly wouldn't do any good.
Start the meeting calm and non-accusatory. Simply ask for the written agreement that authorizes these charges. You know there isn't one. They know there isn't one, but force them to admit it. If they do admit it, then you are home free for the back-dated charges.
If they say they will find it and get back to you, say, calmly again, "Thank you. As soon as you find it and send it to me, I'll schedule another meeting to work out payments. If there isn't anything else to discuss today, I'll be running along to visit my mother."
OF COURSE it is understandable you are upset. But I think for this first meeting you'll be better off staying calm and business-like. You are simply a person who knows what she is doing and what her rights are and are acting accordingly. No need to raise your voice, or cry, or show how upset you are. You think they have made a mistake and are confident they will correct it. You may need to show how upset you are in a future meeting, but to start with, play it cool.
If there was no agreement, there can be no bill. The facility owns the burden of proving that fee-for-service work had been submitted for approval by the person named as responsible for the resident.
You say that they need to provide IN WRITING to you proof of who, how, when the services were ordered and approved for billing. And if they don't, call the better business bureau and get an attorney.
I think this is more a notice of a price increase than anything else. Sans contract, that debt is uncollectible. But I suspect mom's rate is going to increase substantially.
I'm guessing that when the business was bought out, the new owners audited the special services everyone was getting and put a value on them. It is not unusual at all for ALFs to charge for accompanying to the dining room, help dressing, bathing, etc etc. perhaps the previous owners weren't doing that.
As I said, I think the bill is unenforceable. Their reasoning may be that you will object less to a substantial price increase when they symbolically back bill you.
I think someone at AL just did a major goof. If your mother did not contract for certain services, she can't be held responsible to pay. I can't imagine why they would suddenly come up with this unless they were trying to force people out.
Thank you Jeanne. There isn't one. This is out of the blue. I contacted corporate and they asked me the same thing! So, what do I say when I go to the meeting tomorrow? I'm (hopefully understandably) upset. I have all my previously (paid) statements and the new one. Would it be reasonable to demand that the back charges be removed? And how would I word that? Oh, and yes, we are up to date with all billings. Always have been.
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I think one of the worst examples was $14.00 for a tube of chapstick (containing petrolatum) sold at grocery stores for about $2.00 (+/-) for someone on oxygen who can't use anything containing petrolatum.
It's also reassuring to hear about a good organization; there are so many horror stories of ones that aren't.
And it's also especially helpful to know how a situation was resolved in case some of us find ourselves in a similar predicament.
Thanks for sharing.
That's what I was hoping for, and I must say they were very good. I do like the facility and the care they give.
Hey! There are good places and good people out there! Just have your paperwork in order! :)
Comments please?
Although nothing was resolved today, I did agree to pay the non-disputed amount and there will be no late fees or penalties on the remainder. Apparently something happened in the transition and there will be a thorough review as to what happened and why. There was no documentation that I was ever notified of anything.
They also listened to me as to what I'd like, which is that to pull $ out of my hat would create undue hardship and if there was a mistake of under billing that we should renegotiate going forward, not back and I seemed to get head-nods, but no promises. There will be another meeting next week.
Oh, and went armed with all my paperwork and invoices for the past year. They made copies.
So we shall see. Please send me good thoughts!
Everyone's given you good advice, especially the documentation and the advice to stay calm, which I know is hard to do - when I've been in a similar situation, it's easy to become angry.
Sometimes thinking of this situation as doing it for a friend rather than your family helps to create enough distance that you can be more calm. Take yourself and your family out of the picture and pretend you're handling this as a representative for a friend.
And there's always the old adage, low class as it may be, to think of them sans clothing and they'll be less intimidating. And please excuse the rather vulgar nature of that suggestion, but it does work.
If there's anyone who can go with you, it won't be you vs. x number of them, and my experience is that typically there will be a lot of talking or nontalking, just staring faces all trying to intimidate you.
You know of course that if you don't know what to say, don't say anything. Just stare back at them, and let them squirm. Then you can reiterate that you need their documentation before you can discuss anything.
I would offer that you commit as well only to reviewing all the DETAILED, LINE ITEM charges that you expect them to provide. They may try to get you to commit to an agreement to pay; don't. Advise that you can't agree to anything until you've seen their alleged data and documentation. Shift the entire burden of action to them.
And please let us know how this turns out after tomorrow's meeting.
Good luck, keep your cool, and as the old saying goes "sock it to them!"
If they get pushy in the meeting and threaten to throw your mom out on the street, just quietly state that you know they can't do that legally. But if they do, call 911 and have them take mom to the hospital, NOT YOUR HOUSE.
Then call Dept Human Serivces crisis hotline and make a complaint while you are still on the property.
Tell the facility that you will need an opportunity for legal review of the bill and the service approvals, and expect to follow the policy outlined in the lease/rental agreement for evictions, considering all other bills are up to date.
Before you meet with them, find that contract and read it carefully for instructions on how billing disputes are handled because there will be a timeline in there. They should have sent you formal notice by mail when any rate changes were made in the past. I get a letter when the beauty shop raises rates, so rate changes on add-on services would definitely have a notice sent out.
Make absolutely sure there weren't any past rate changes that you could have missed, that would have meant something is really now in arrears.
If they say they will find it and get back to you, say, calmly again, "Thank you. As soon as you find it and send it to me, I'll schedule another meeting to work out payments. If there isn't anything else to discuss today, I'll be running along to visit my mother."
OF COURSE it is understandable you are upset. But I think for this first meeting you'll be better off staying calm and business-like. You are simply a person who knows what she is doing and what her rights are and are acting accordingly. No need to raise your voice, or cry, or show how upset you are. You think they have made a mistake and are confident they will correct it. You may need to show how upset you are in a future meeting, but to start with, play it cool.
You say that they need to provide IN WRITING to you proof of who, how, when the services were ordered and approved for billing. And if they don't, call the better business bureau and get an attorney.
I think this is more a notice of a price increase than anything else. Sans contract, that debt is uncollectible. But I suspect mom's rate is going to increase substantially.
I'm guessing that when the business was bought out, the new owners audited the special services everyone was getting and put a value on them. It is not unusual at all for ALFs to charge for accompanying to the dining room, help dressing, bathing, etc etc. perhaps the previous owners weren't doing that.
As I said, I think the bill is unenforceable. Their reasoning may be that you will object less to a substantial price increase when they symbolically back bill you.
Good luck and let us know what happens.