MEDICARE AND SKILLED CARE

posted Oct 25, 2012, 6:14 AM by Frank Baskin   [ updated Oct 25, 2012, 6:17 AM ]
CMS(Center for Medicare and Medicaid Services) has agreed to change its eligibility rules for those who need skilled nursing home and also in-home and ...CLICK TITLE FOR MORE.... outpatient care. Individuals will no longer have to show that they are improving in order to receive skilled care(in a nursing home or in the commnity).
 
Read the following:
 

Under the agreement, which amounts to a significant change in Medicare coverage rules, Medicare will pay for such services if they are needed to “maintain the patient’s current condition or prevent or slow further deterioration,” regardless of whether the patient’s condition is expected to improve.

Federal officials agreed to rewrite the Medicare manual to make clear that Medicare coverage of nursing and therapy services “does not turn on the presence or absence of an individual’s potential for improvement,” but is based on the beneficiary’s need for skilled care.

This agreement was based on a class action law suit which was brought against the Federal government.
Look for  more information later about specifics and implementation date.
 
Clearly, some  residents will be able to stay longer in their Medicare A bed. This does not impact the maximum number of days allowed on one stay. Others will be able to continue their community based rehab services.
It will cost the Federal government additional dollars tho there may be some savings if services prevent admission to a nursing home or keep someone out longer.
 

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