Skilled nursing facilities (SNF) are required to develop a care plan for each beneficiary and provide services in accordance with the care plan, as well as to plan for each beneficiary's discharge. These requirements are essential to ensuring that beneficiaries receive appropriate care and safely transition from one care setting to another. Several OIG studies and investigations found that SNFs had deficiencies in quality of care, did not develop appropriate care plans, and failed to provide adequate care to beneficiaries. In fiscal year 2012, Medicare paid $32.2 billion for SNF services. This study is part of a larger body of…
Medicare Part A covers institutional care in hospitals and skilled nursing facilities, as well as certain care given by home health agencies and care provided in hospices. Any person who has reached age 65 and who is entitled to Social Security benefits is eligible for Medicare Part A without charge. That is, there are no premiums for this part of the Medicare program. Medicare Part A covers up to 100 days of "skilled nursing" care per spell of illness. However, the conditions for obtaining Medicare coverage of a nursing home stay are quite stringent. Here are the main requirements: The…
In a major change in Medicare policy, the Obama administration has provisionally agreed to end Medicare’s longstanding practice of requiring that beneficiaries with chronic conditions and disabilities show a likelihood of improvement in order to receive coverage of skilled care and therapy services. The policy shift will affect beneficiaries with conditions like multiple sclerosis, Alzheimer’s disease, Parkinson’s disease, ALS (Lou Gehrig’s disease), diabetes, hypertension, arthritis, heart disease, and stroke. For decades, home health agencies and nursing homes that contract with Medicare have routinely terminated the Medicare coverage of a beneficiary who has stopped improving, even though nothing in the Medicare…
Representatives of Attorney General Kamala D. Harris have said the state will begin aggressively building more criminal cases statewide. Harris' office is forming three specialized teams –one in Sacramento, two in Southern California– to pursue criminal charges against nursing home administrators and employees where deep, systemic problems are suspected. "Elder abuse is a particularly tragic crime because it targets a beloved population –our aunts and uncles, our parents– at what can be a vulnerable time in their lives," said Harris in a prepared statement, referring to these crimes as ‘serious and often hidden.’ “We know abuse of our elders is…
Fortunately, there are plenty of helpful tools, as indicated below. For your FREE Assisted Living Guide or Nursing Home Guide please contact our office. Also here are a few sites worth checking out: The U.S. Administration on Aging’s Resource Center, which has links to other sites, including the agency’s Eldercare Locator service. The National Association of Area Agencies on Aging, which will let you find your local agency on aging as well as information about housing options for the elderly. The Department of Health and Human Services National Clearinghouse for Longterm Care Information, a guide to long-term-care choices. Medicare’s Nursing…
Many people share a common misconception that Medicaid Planning is not in the best interest of nursing homes. At the same time, many nursing homes are now recognizing that without proper Medicaid planning, some residents who have spent down all of their assets are not automatically qualified for Medicaid…leaving the nursing home with a very large, uncollectible bill. And, as many of you are aware, non-spouse family members are not responsible to pay the nursing home bill for their relative. If the resident is unable to pay and they do not qualify for Medicaid, the nursing home will have a…
Families really need to do lots of research. Use the internet, visit the neighborhoods and facilities and look for reviews that are done by people that have had their family members in the nursing home. Search for a facility where your loved one’s immediate needs are met, ask questions, see if they have an available rehabilitation center, what foods they will serve, how they can cater to your loved ones, what insurance the nursing home will take. For more contact our office for the FREE booklet “Nine “Must Ask” Questions Before Entering A Nursing Facility”
Our Nursing Home Guide will provide you direction if you or a loved one is facing the decision of looking at nursing homes or Medicaid in Maryland. Keep peace of mind with the information you need to insure your future security. Having a chronic, long-term debilitating illness such as Alzheimer’s Disease, Multiple Sclerosis, Parkinson’s Disease, Stroke or Arthritis can be extremely frightening and can create a great deal of uncertainty and insecurity for both the patient and his or her loved ones. The fear associated with the loss of control over the mind and/or the body coupled with fears of financial ruin can result…
The traditional model for these facilities is institutional, with facility designs and procedures based on mass efficiency instead of individual concern for the well-being of each resident. At the Elder Law Office of David Wingate we appreciate that this "regimented" lifestyle is feared by many local residents who likely have personal stories of friends or family members who lived unhappily in one of these facilities. Some seniors even “put off” estate planning and asset protection strategies, because thinking about these issues is unpleasant and many would prefer to just avoid the issue altogether. Of course, failure to plan for long-term…
Medicare has detailed information about every Medicare and Medicaid-certified nursing home in the country. Before you get started, you or your family member may have other long-term care choices like community-based services, home care, or assisted living depending on your needs and resources. Otherwise, click on the above and follow the steps when choosing a nursing home: Step 1: Find Nursing Homes in your area. Search by name, city, county, state, or ZIP code. Step 2: Compare the quality of the nursing Homes you're considering using the Five-Star Quality Ratings, health inspection results, nursing home staff data, quality measures,…
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