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Nursing Homes Abuse Blog By Jonathan Rosenfeld

Category Archives: Medicare

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More Improvements At Medicare’s ‘Nursing Home Compare’ Website

Posted in Medicare

We spend a lot of time talking about the problems with modern-day nursing homes, but I find the most important improvement in U.S. nursing homes is the development of Medicare’s nursing home compare website.  The site provides a one-stop-shop for families seeking information on a particular facility or when researching facilities within a particular area…. Continue Reading

Federal Court Decision Opens The Door For Expanded Medicare Coverage For Skilled Nursing Care & Home Health Care

Posted in Medicare

Recent decisions by Federal Courts in Pennsylvania and Vermont may pave the way to extended Medicare benefits to individuals with chronic medical conditions.  If the decisions are upheld, no longer will a Medicare recipient be required to demonstrate that their condition will improve in order for the treatment to be covered under Medicare. These decisions… Continue Reading

When The Going Gets Tough, Some Nursing Homes Turn To Medicare & Medicaid Fraud

Posted in Medicare, Whistleblower / Qui Tam Claims

When it comes to boosting their bottom line, some nursing homes will stop at nothing– including stealing from taxpayers.  Because many nursing home patients are elderly or too frail to verify all the charges a nursing home submits to Medicare on their behalf, it is relatively easy for nursing homes to add extra charges for… Continue Reading

Should Medicaid Dictate Who Receives Medical Treatment?

Posted in Medicare

An anticipated decision by the 11th Circuit Court of Appeals may alter the way medical treatment is dispensed for Medicaid recipients.  Under the current system, Medicaid recipients are entitled to receive ‘medically necessary’ treatment as prescribed by their physician.  In cases of disabled or handicapped people this frequently means home nursing care by a CNA… Continue Reading

New Pay-For-Performance Program Initiated To Help Improve Nursing Home Care

Posted in Medicare

Nursing homes will now have one more reason to improve patient care–they will be paid for doing so. The Centers for Medicare & Medicaid Services (CMS) will initiate a new pay-for-performance program to inspire nursing to provide improved care to residents. The plan formally known as,  Nursing Home Value-Based Purchasing Demonstration Project, will begin in July… Continue Reading

If I Work In A Nursing Home Where I Suspect Fraud, Can I File A Qui Tam or Whistleblower Lawsuit?

Posted in Medicare, Nursing Home Staff, Whistleblower / Qui Tam Claims

Yes. Under the Federal Civil False Claims Act (31 U.S.C., Section 3729), private citizens act on behalf of the Federal or State Government to bring an action against government contractors or any company who acts fraudulently with government funds. Under the False Claims Act, a qui tam lawsuit entitles individuals employed by the entity guilty… Continue Reading

Is Medicare Entitled To Receive A Portion Of My Settlement From A Nursing Home Case?

Posted in Frequently Asked Questions, Medicare

Yes.  In nursing home negligence cases, if Medicare and/or Medicaid paid any medical expenses on your behalf, the agencies are entitled to be reimbursed. Federal laws impose a Medicare and/or Medicaid lien on all injury-related cases involving a recovery from a third-party. Because many nursing home residents are recipients of Medicare and/or Medicaid, it is… Continue Reading

Does Pulling Medicare Funding From Underperforming Nursing Homes Help Residents?

Posted in Medicare

Its a fine line between ordering an under performing nursing home to close its doors versus giving the facility an opportunity to improve.  Many of the ‘under-performing’ facilities are responsible for caring for some of the most challenging residents–those that other facilities are incapable or simply refuse to care for.  In the end, resident safety… Continue Reading

Medicare Pulls Funding From Troubled Nursing Home Due To Concerns Over Resident Safety

Posted in Medicare

Residents of the River Park Nursing Home in Nashville, Tennessee will be forced to find a new place to live within the next  30 days.  Medicare has pulled its funding for the facility following state inspections that revealed safety violations that threatened the health of the residents.  Although the facility could continue to operate with… Continue Reading

Nursing Homes Abuse Blog Featured On ‘Ask Mr. Eldercare’ Radio Program

Posted in Help For Residents & Families, Medicare

Last week, I had the honor of being invited to Martin Sabel’s, a/k/a Mr. Eldercare, radio program, ‘Ask Mr. Eldercare’ to discuss the new Medicare rating system for nursing homes.  It was great fun to discuss this new development in nursing home care with such a knowledgeable man.  Martin has helped thousands of families handle… Continue Reading

Medicare No Longer To Pay For ‘Reasonably Prevenatable’ Medical Errors

Posted in Medical Malpractice, Medicare

As of October 1, 2008 Medicare is no longer reimbursing hospitals for reasonably preventable medical errors.  The medical facilities will similarly no longer be able to charge patients directly for medical care resulting in errors.  Called ‘never events’–because the medical errors were never intended to occur, the below is a list of the never events… Continue Reading

Medicare & Medicaid Funding Pulled From Nursing Home With Violations

Posted in Medicare, National Nursing Home Issues

Residents at Michigan’s Metron Nursing Home in Allegan will soon be looking for new places to live following the facilities violations of  federal nursing home regulations.  Metron has received 11 federal violations, including a violation concerning immediate jeopardy to a patients health.  It is unfortunate that resident’s must be displaced and care routines will be interrupted,… Continue Reading

Government Funding Pulled On Dangerous Nursing Home

Posted in Medicare

The Green Meadows Health Care Center in Louisville, Kentucky has lost its Medicare and Medicaid funding after repeatedly putting their residents at risk for danger and not investigating resident injuries.  No specific act of wrong doing is cited in the denial of government funding.  Rather, the nursing home  has received numerous type ‘A’ citations.  Type… Continue Reading

The List Of ‘Never Events’ Grows

Posted in Medicare

Effective 10/1/2008, hospitals and nursing homes will no longer be able to seek reimbursement from Medicare for medical conditions deemed preventable.  The Centers for Medicare & Medicaid Services is asking states to coordinate Medicare and Medicaid policies to prevent facilities from billing Medicaid for preventable medical errors for individuals who may be eligible for both… Continue Reading

Nursing Home Residents Expected To Shoulder More Financial Burden

Posted in Medicare

Many disabled and elderly residents of New York will soon be expected to pay more personal funds toward their nursing home expenses.  The changes are being implemented to minimize government spending by reducing the number of people eligible for Medicaid.  Medicaid was originally conceptualized as a program to protect the poor and disabled.  As the… Continue Reading

Spotlight On Medicare Funding For Nursing Homes

Posted in Medicare

Fact is most nursing homes and other long-term care facilities rely in small or large part on funding from Medicare.  Most elderly do not have the assets to live in swank nursing homes that have maid service and four star chefs.  Part of the nursing homes responsibility in accepting Medicare and Medicaid funding is that… Continue Reading

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