By Bob Moos,
Southwest regional public affairs officer for the U.S. Centers
for Medicare and Medicaid Services.
When you hear about Medicare, you probably think of the federal program that helps pay for older adults’ health care. What you may not realize is that another of Medicare’s major responsibilities is to inspect health care facilities to make sure that patients receive safe and high-quality care.
Among those facilities are the nation’s more than 15,000 nursing homes.
Nursing facilities wanting to get reimbursed for treating Medicare patients must be certified as meeting certain health and safety requirements. The federal agency that oversees Medicare – the U.S. Centers for Medicare and Medicaid Services – works closely with the states to accomplish that.
Trained health professionals make unannounced visits to nursing homes to check whether the health and safety standards are being met and, if not met, to ensure the problems are addressed. An inspection is often the result of a complaint lodged by a patient or family member.
Nursing homes that don’t promptly correct their shortcomings may be subject to fines. If the health and safety violations persist and pose a serious enough threat to patients, the facilities may be terminated from the Medicare program and forbidden to bill the government for patient care.
Unless and until a nursing home actually loses its Medicare funding, this regulatory process often goes unnoticed by the general public. But you can see how the nursing homes in your community have fared in recent health and safety inspections by visiting Medicare’s Nursing Home Compare website – at www.medicare.gov/nhcompare.only when it’s time for the next transaction or payday on their behalf. It is vital to cultivate these adversarial type of relationships by offering consistent, open and honest dialogue with one another. If you’re experiencing hard times or turbulence in your company, say so. Perhaps they can suggest pulling certain levers or initiate some changes, which could alleviate some of the duress.
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