The Settlement Agreement in Jimmo v. Sebelius, No. 5:11-CV-17 (D. Vt) was approved by a federal district court in January 2013. Unfortunately, more than six years since the Settlement’s approval, the Center for Medicare Advocacy still regularly hears from beneficiaries facing erroneous “Improvement Standard” denials in home health, skilled nursing facility, and outpatient therapy settings. As a result, the Center advises beneficiaries and their families to continue citing the Jimmo Settlement and related materials when challenging denials based on an erroneous “Improvement Standard.” Source/more: Center for Medicare Advocacy See also: CMS Statement about Jimmo For a complete list of upcoming seminars,…
Information Disclosure – You have the right to receive accurate and easily understood information about your health plan, health care professionals, and health care facilities. If you speak another language, have a physical or mental disability, or just don’t understand something, assistance will be provided so you can make informed health care decisions. Choice of Providers and Plans – You have the right to a choice of health care providers that is sufficient to provide you with access to appropriate high-quality health care. Access to Emergency Services – If you have severe pain, an injury, or sudden illness that convinces…
What happens if you paired the very young with the very old? It’s being done at a preschool in Seattle, where child care takes place throughout a campus which is also home to more than 400 older adults. Called the Intergenerational Learning Center, the preschool is located within Providence Mount St. Vincent, a senior care center in West Seattle. Five days a week, the children and residents come together in a variety of planned activities such as music, dancing, art, lunch, storytelling, or just visiting. And now this incredible place is about to have its own film. Called “Present Perfect,”…
California’s largest nursing home chain has come under fire from government regulators, facing a flurry of citations and penalties. Brius Healthcare Services has 81 facilities stretching from San Diego to Roseville to Eureka. In the past year, some of the facilities have become the target of police scrutiny, lawsuits, stiff regulatory fines, and state and federal investigations that have uncovered numerous alleged violations, the Sacramento Bee reported Sunday. Between October and January, three of Brius’ facilities were decertified by the federal government, which yanked its Medicare and Medi-Cal funding, an economic kiss of death that is extremely rare. In comparison,…
Last November, in what the U.S. Department of Justice called “one of the largest health care fraud settlements in U.S. history,” Johnson & Johnson and its subsidiaries were fined more than $2.2 billion to resolve criminal and civil charges because of their aggressive marketing of drugs, including antipsychotics, to nursing homes, when they knew the drugs had not been approved by the U.S. Food and Drug Administration (FDA) as safe and effective for a general elderly population. The corporation also allegedly paid kickbacks to physicians, as well as to Omnicare, the nation’s largest long-term-care pharmacy provider. Omnicare pharmacists were recommending Johnson…
THINKING ABOUT NURSING HOME CARE, OR MEDICAID? The decision to move a family member into a nursing home is one of the toughest and most difficult decisions you can ever make. Over time, caring for an aging or disabled love one can deplete your energy, time and finances. The legal and financial ramifications can cost you plenty. Your income, assets and financial security can be a serious risk. Stop, before it’s too late. If you and your family are overwhelmed or confused by all the decisions you have to make. If you want to know your individual rights, or this…
The Illinois Department of Public Health conducted an investigation concerning an automobile accident involving a 79-year-old female resident who was under the care Community Living Options, Inc., an intermediate-care facility for the developmentally disabled. The resident was diagnosed with mental retardation, cerebral palsy, speech and hearing impairment, and dementia. Defendant's employee was driving a facility van with the subject resident and two other residents. A truck braked in front of the van and the employee braked to avoid the truck. The resident came forward and hit the dash with her head. She was transported to a hospital and died the…
A KVUE Defenders investigation uncovered cases of nursing home neglect on the rise across Texas. The investigation also discovered that facilities repeatedly cited for violations rarely see their contracts terminated with the state, despite getting millions in taxpayer dollars. According to the Department of Aging and Disability Services (DADS), deficiencies involving Texas nursing homes jumped from 14,215 in 2011 to 15,113 in 2012. The most severe violations, which put patients in immediate danger, increased by 35 percent. "This is crisis mode right now for Texas," said Brian Lee, Executive Director for Families for Better Care. Earlier this year, the nonprofit…
Nursing homes will face survey citations for facility-wide policies that prohibit cardiopulmonary resuscitation for residents, according to a recent Centers for Medicare & Medicaid Services memorandum. Research has shown that CPR is not very effective in the elderly nursing home population, and some facilities have put in place general no-CPR policies, the memo states. However, this does not comply with federal regulations that guarantee the right of residents to formulate advance directives. Therefore, nursing homes are prohibited from establishing and implementing these blanket policies, according to CMS. If an advance directive or do-not-resuscitate order is not in place for a…
The month of October is a time to recognize residents across all long-term care settings. The theme for 2013 by the National Consumer Voice for Quality Long-Term Care is “Speak Out Against Elder Abuse.” The Consumer Voice hopes to empower and educate residents around the issue of elder abuse. Learn more about the events for Residents’ Rights Month.
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