I have heard many stories over the years of families that fight to keep a nursing home resident getting physical, occupational, or speech therapy. It used to be that if there was a determination that a resident wasn’t progressing anymore, then Medicare or Medicaid did not pay, and the therapy was discontinued.
In an excellent decision, the New Jersey Supreme Court agreed with the plaintiff in this case who cried foul after the Medical Center decided to wait until nearly two years after litigation was completed before attempting to deprive her of her right to a trial by jury.
In October 2008 Medicare introduced a new reimbursement system, based upon 2002 industry standards, otherwise known as “never events.”
HealthBridge Management, a nursing home company, was forced to take back workers who were on strike after a federal judge found the management company to not be negotiating in good faith. HealthBridge was imposing significant wage and benefit cuts before negotiations were deadlocked.
One of the most common mental conditions we see with nursing home residents is Alzheimer’s disease. It can be very difficult for a family to watch a family member slowly slipping away mentally. This condition can also increase someone’s risk for falls and other injuries.
With the passing of the Affordable Care Act (ACA), this nation has seen the beginning of a dramatic shift in both the delivery of healthcare and the means by which payment is made for medical services. Under the ACA, a new type of medical agency was created, known as Accountable Care Organizations (ACO). These entities are required to coordinate all levels of care in a fashion that is both more efficient and better focused on the provision of quality care
Congress has recently proposed House Resolution 5, an extreme bill that would limit our rights and offer a handout to the medical industry by allowing it to go virtually unpunished when patients are harmed or killed. A recent report states that one out of every three hospital patients is sickened, injured, killed or otherwise harmed because of a medical error. This study is just one more, in a long list of reasons why this bill should not be passed.
Currently pending in congress is bill HR5 sponsored by Representative Phil Gingrey. If HR5 passes, it would protect some of the worst nursing homes from even the most egregious abuses by severely limiting damages.
In two short months, we will face a new congress – who’s stated primary goal is to remove the historic healthcare bill and expose numerous patients across the country to a lack of access to medical care. Conspicuously absent from most press releases or even the debate is the devastating personal and economic impact of medicare fraud. Here is a fascinating and disturbing study on its scope.
I recently wrote an article for the New Jersey Law Journal about the new Medicare Guidelines for Hospitals and Never Events. After some additional research, I have learned that many insurance companies agree that it is unfair for negligent hospitals to pass costs related to their mistakes along to others.
