Medicare Advocacy and Nursing Home Residents Rights

Medicare Coverage for Nursing Home Residents.

In this educational session we provide a Medicare overview, talk about about Medicare nursing home coverage, find out where residents can get help, and also provide time for specific Q&A's to be answered.

Session 1: PowerPoint Slides Link

Session 1 Transcript Link

Know Your Rights: Medicare Discharges and Nursing Home Admissions 
In this Presentation CMA and LTCOP review your rights and protections regarding the following topics: Medicare vs. Medicaid Coverage, Distinct notice and appeal rights for discontinuance, Third-Party Guarantees, how to handle admission agreements, practical advice on reviewing admission agreements, and filing complaints against abusive practices.

• Know Your Rights: Caregivers and Nursing Home Debt from the consumer financial protection bureau - https://www.consumerfinance.gov/consumer-tools/educator-tools/resources-for-older-adults/know-your-rights-caregivers-and-nursing-home-debt/

• Nursing Facility FAQ by National Consumer Law Center" - https://www.nclc.org/wp-content/uploads/2023/09/Nursing-Facility-FAQ-1.pdf

• National Center on Law and Elder Rights Informational - Nursing Home Debt Collection: Issues and Defense (July 2024) - https://pfs2.acl.gov/strapib/assets/Nursing_Home_Debt_Collection_Tip_Sheet_bead3aee8d.pdf

• National Center on Law and Elder Rights Presentation Slides – Nursing Home Debt Collection Against Residents, Caregivers, and Other Third Parties (July 2024) - https://pfs2.acl.gov/strapib/assets/7_23_24_Nursing_Home_Debt_Collection_slides_95b74e3bc1.pdf

• National Center on Law and Elder Rights Recording – Nursing Home Debt Collection Against Residents, Caregivers, and Other Third Parties - https://vimeo.com/989117592

• CMA Article Summarizing Medicare Denials Process and Resident Rights https://medicareadvocacy.org/discharge-from-a-skilled-nursing-facility-what-does-it-mean-and-what-rights-does-a-resident-have/

   

• CMA Know Jimmo | Frequently Asked Questions

   

  • https://medicareadvocacy.org/know-jimmo-frequently-asked-questions/?emci=b6c06f2c-a94a-ef11-86c3-6045bdd9e096&emdi=ad2d6f65-c24a-ef11-86c3-6045bdd9e096&ceid=9809440

Medicare Denial and Appeal Rights / Resources

• Self Help Packet for Medicare Denials
• https://www.medicareadvocacy.org/take-action/self-help-packets-for-medicare-appeals/
  
  
• Toolkit: Medicare Skilled Nursing Coverage and Jimmo v. Sebelius
• https://www.medicareadvocacy.org/wp-content/uploads/2018/01/Medicare%20SNF%20Coverage%20and%20Jimmo%20v.%20Sebelius%20Toolkit.pdf

• Self Help Packet for Medicare Denials in Long Term Care Settings
• https://www.medicareadvocacy.org/self-help-packet-for-expedited-skilled-nursing-facility-appeals-including-improvement-standard-denials/#SHIP

• New Center for Medicare Advocacy Form to Contest Multiple Denials from Managed Medicare Plans
• https://medicareadvocacy.org/new-from-the-center-form-to-contest-multiple-medicare-denials-issued-by-medicare-advantage-plans/
  
  
• Medicare and Homecare
• https://medicareadvocacy.org/when-should-medicare-coverage-be-available-for-home-health-care/?emci=467478f3-b1c6-ee11-85f9-002248223794&emdi=1bc76ec6-c7c6-ee11-85f9-002248223794&ceid=9809440
• Form to Contest Multiple Medicare Denials Issued by Medicare Advantage Plans.

Download the form and instructions at https://medicareadvocacy.org/wp-content/uploads/2022/08/MA-Grievance-Form.docx