The Medicaid lawyers of Clarity Legal Group®, serving Raleigh, Durham, Cary, Chapel Hill and surrounding areas, help seniors to make certain they can pay for nursing home care. In most cases, nursing home care has to be paid for by Medicaid because Medicare won’t cover it. Medicare only pays for skilled nursing care and provides coverage only in very specific situations. That’s why Clarity Legal Group® works with seniors to help them become eligible for Medicare coverage and ensure they can afford the care they require without impoverishing themselves first. 
While Medicare doesn’t pay for nursing home care in most situations, it does over skilled nursing care under certain limited circumstances. However, to be eligible for these payments, the nursing home must meet certain federal standards. Care facilities also need to comply with federal requirements if they want to receive Medicaid payments as well.
Seniors should pay attention to whether a nursing home is Medicare eligible, regardless of how they will be paying for a nursing home, because in some cases care facilities become ineligible for obtaining Medicare payments because the facility provides substandard care. In fact, just recently, WRAL reported that the Medicare program was considering preventing several North Carolina nursing homes from receiving Medicare payments as a result of serious problems at the care facility.
North Carolina Nursing Homes Could Be Kicked out of Medicare Program
According to WRAL, the Centers for Medicare and Medicaid Services recently contacted two nursing home care facilities in the state of North Carolina. Centers for Medicare and Medicaid Services alerted the care facilities they weren’t in “substantial compliance” with federal regulations of nursing homes.
These warnings came after investigators from the state of North Carolina confirmed that an allegation of abusive behavior at a Raleigh, NC facility was a credible allegations of abuse.
The allegation of abuse arose when the daughter of a 68-year-old nursing home resident set up a hidden video camera in her father’s room. Her father had been sent to the care facility while he was recovering from a stroke, and her father insisted that he was receiving substandard care.
The hidden video recorded on the secret cameras revealed that the 68-year-old stroke victim had fallen out of his bed. Staff members did not respond to his plea for help for around an hour after he requested assistance. When staff members did respond to assist him, they berated him for falling out of the bed.
The care facility indicated the staff members who engaged in the improper behavior have been terminated and they indicate that other remaining staff members have since been provided with additional training.
Despite the center’s insistence it had solved its issues, a state inspection revealed ongoing problems and Centers for Medicare and Medicaid Services gave the facility a deadline by which it must come into compliance with federal regulations or risk losing access to Medicare.
When a care facility is no longer eligible to receive Medicare payments, it will not be reimbursed for patients who qualify for Medicare coverage for skilled nursing care.
Getting Help from Triangle Medicaid Lawyers
Triangle area Medicaid lawyers at Clarity Legal Group® can help you to make certain you are able to get your nursing home care paid for in a quality care facility. We can also help you to make a plan to find a nursing home that doesn’t have a history of serious problems including allegations of abuse and neglect.
By taking steps in advance of the time that you need nursing home care to make certain that you can find the right facility and cover the costs, you can increase the likelihood of getting the best possible care as a senior. To find out more, give us a call at 919-484-0012 or contact us online today.
- What Are the Drawbacks to Creating an ABLE Account? - May 15, 2023
- What Is an ABLE Account? - May 5, 2023
- What Is the Medicaid “Look-Back” Provision? - March 6, 2023
