This is the sixth in a series of Alerts by Center for Medicare Advocacy regarding Patient Protection and Affordability Care Act of 2010 (PPACA) and the Health Care and Education Reconciliation Act of 2010 (HCERA). This Alert focuses on provisions … [Read more...] about Health Reform: The Nursing Home Provisions
Skilled Nursing Facility
New GAO Report Demonstrates Need for Stronger Enforcement of Nursing Home Quality Standards: Health Reform Provisions Could Help
The Patient Protection and Affordable Care Act of 2010 (PPACA), the health care reform legislation enacted earlier this year, provides a new opportunity to strengthen and improve federal oversight mechanisms for nursing homes. Implementation of new … [Read more...] about New GAO Report Demonstrates Need for Stronger Enforcement of Nursing Home Quality Standards: Health Reform Provisions Could Help
Off-Label Drug Use Is Common and Hurts Nursing Home Residents
Introduction The three-year old, and still ongoing, investigation and criminal prosecution of former staff members of a California skilled nursing facility for improper use of antipsychotic drugs on residents raises issues that go far beyond the … [Read more...] about Off-Label Drug Use Is Common and Hurts Nursing Home Residents
Overcoming Barriers to Medicare Coverage of Skilled Nursing Facility Care
On March 10, 2010 NCCCNHR, The National Consumer Voice for Quality Long-Term Care, along with the Center for Medicare Advocacy hosted a web seminar on overcoming barriers to skilled nursing care, presented by Center Senior Policy Attorney Toby S. … [Read more...] about Overcoming Barriers to Medicare Coverage of Skilled Nursing Facility Care
Observation Services: What Can Beneficiaries and Advocates Do?
What are Observation Services? CMS Brochure Favorable Decisions What Should Beneficiaries and their Advocates Do? Continuing WorkBeing in a hospital bed in a … [Read more...] about Observation Services: What Can Beneficiaries and Advocates Do?
Nursing Home Residents’ Access to Physicians and Pain Medication
Whether federal law and policies are preventing nursing home residents from getting the pain medications they need has become a major concern. In May 2009, the Milwaukee Office of the Drug Enforcement Administration (DEA) received a tip that … [Read more...] about Nursing Home Residents’ Access to Physicians and Pain Medication
“Observation Status” Harms SNF Patients As Well As Hospital Patients
Advocates at the Center for Medicare Advocacy are working on a case involving an individual who was in a hospital bed for four days but was never "formally admitted". Instead, the hospital accorded her "observation status". … [Read more...] about “Observation Status” Harms SNF Patients As Well As Hospital Patients
Serious Deficiencies in Nursing Facilities are Understated and the Problem May Get Worse
Nursing facilities that choose to participate in the Medicare or Medicaid programs, or both, must undergo an annual survey to determine their compliance with federal standards of care, which are called Requirements of Participation.[1] Facilities … [Read more...] about Serious Deficiencies in Nursing Facilities are Understated and the Problem May Get Worse
When is Hospital Stay NOT a Hospital Stay? When the Patient Is In “Observation Status”
The Medicare statute and regulations authorize payment for skilled nursing facility (SNF) care for a beneficiary who, among other requirements, was a hospital inpatient for at least three days before the admission to the SNF. The Center for … [Read more...] about When is Hospital Stay NOT a Hospital Stay? When the Patient Is In “Observation Status”
Illegal “Improvement Standard” for SNF Coverage Terminated
Over the years, contractors that review Medicare claims have denied coverage for Medicare services inappropriately on the grounds that the beneficiary's condition will not improve. The Center for Medicare Advocacy, through individual appeals and … [Read more...] about Illegal “Improvement Standard” for SNF Coverage Terminated