Search Results for: maintenance

Medicare home health coverage is misunderstood and too often denied. This is particularly true for people with longer-term and chronic conditions who are unable to obtain Medicare coverage although they meet the benefit’s criteria – are homebound and … [Read more...] about Know Jimmo | Medicare Home Health Coverage Does Not Require Improvement

Coverage does not turn on the presence or absence of potential for improvement but rather on the need for skilled care. Skilled maintenance therapies and nursing are covered by Medicare. Claims should never be denied because patient cannot achieve … [Read more...] about Know Jimmo | What It Means

Medicare IS available for skilled care to maintain or slow decline of an individual’s condition.“Restoration potential is not the deciding factor in determining whether skilled care is required. Even if full recovery or medical improvement is not … [Read more...] about Know Jimmo | No Matter Who’s In Charge – Jimmo is the Law

“The Jimmo Settlement Agreement may reflect a change in practice for those…who may have erroneously believed that the Medicare program covers nursing and therapy services under these benefits only when a beneficiary is expected to improve. The Jimmo … [Read more...] about Know Jimmo | Important Message about the Settlement

“Maintenance Therapy – Therapy services in connection with a maintenance program are considered skilled when they are so inherently complex that they can be safely and effectively performed only by, or under the supervision of, a qualified therapist. … [Read more...] about Know Jimmo | Medicare Covers Therapy in Nursing Homes to Maintain or Slow Decline

The standards established by Jimmo v Sebelius apply to four health care settings. They include:1. Skilled Nursing Facility,2. Home Health, and,3. Outpatient Therapy (PT, SLP/ST, OT)4. Inpatient Rehabilitation Hospital (Facility) (IRF)Skilled … [Read more...] about Know Jimmo | Jimmo Applies to Many Care Settings