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Gainesville Florida Estate Planning & Elder Law Blog

Saturday, August 15, 2015

Twenty Common Nursing Home Problems and How to Fix Them: Here are the Last Ten

    When it comes to relevant laws that pertain to nursing home residents, the amount of knowledge the average person knows is very little. Unfortunately, Nursing Home Reform Law violations are all too common. Knowing common problems and solutions could keep both you and your family members safe. Here are numbers 11-20.

   #11. Refusal to Bill Medicare

Fact – Resident can insist on billing Medicare

Solution – One must first obtain Medicare eligibility and then after, the resident or a representative of the resident must make sure the billing process is sent to Medicare

    #12. Losing Therapy for Supposed Failure to Make Progress

Fact – Therapy is always appropriate, even when progress is not being made

Solution – A lack of progress is no reason to stop and should always be provided. It is consistent with the Medicare rules            

   #13. Losing Therapy After Medicare Payment Has Ended

Fact – Therapy should be provided regardless of the resident’s source of payment

Solution – Convincing the doctor to continue therapy should be the first step along with making sure the nursing home is following through with continuing the process

    #14. Forced Transfer within Nursing Home After Medicare Payment Ends

Fact – A Medicare bed can be occupied by a resident whose care is not being reimbursed

Solution – If a resident does not wish to leave the bed, he should assert his right to veto             

   #15. Refusal to Accept Medicaid

Fact –  A nursing home can certify additional beds for Medicaid payment

Solution- This problem ultimately requires early action and should be obtained before admittance to the facility

    #16. Refusal to Readmit From Hospital

Fact – A Medicaid resident has the right to a Medicaid bed regardless of the hospital stay length

Solution – The resident should never hesitate to assert their right to a Medicaid bed once they return from the hospital. If remittance is denied, the resident may file a complaint with the state.

    #17. Excessive Charges

Fact – A nursing home can only give extra charges if they were agreed to during admission

Solution – There are two options. The resident can first refuse to pay the extra charges with a written explanation. They can also make a complaint to the state agencies

    #18. Refusal to Support Resident and Family Councils

Fact – A nursing home must provide meeting space for resident and family councils

Solution – Strength in numbers. Residents should do their best to make sure the council can run a meeting

    #19.  Eviction Threatened for Being Difficult

Fact – Eviction is allowed for only six limited reasons: failure to pay, no longer needing care, when needs cannot be met, endangers others and the home going out of business

Solution – One must know the only reasons eviction is possible and stand firm when another reason is given

    #20. Eviction Threatened For Refusing Medical Treatment

Fact – Refusal of treatment alone is not a reason for eviction

Solution – Complaining to a higher level in this case is the only way


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