The case of Jimmo v. Sebelius reversed the long held interpretation that a patient must be making rehabilitative improvements in order to meet skilled criteria and be eligible for Medicare coverage.
Duxbury MA (PRWEB) March 16, 2015
The Massachusetts Chapter of Elder Law Attorneys recently sponsored a seminar for staff members of Welch Healthcare and Retirement Group and their colleagues at The Village at Duxbury. The program entitles, How to Overcome the Twin Hurdles to Nursing Facility Rehabilitation Coverage: Hospital Observation Status and the Improvement Standard Under Jimmo, clarified the understanding of Medicare coverage available for older and disabled individuals diagnosed with chronic and long-term medical conditions. Among the speakers were: Nancy Zappolo, director of referral and case management for the Welch Group; Elisa Bovee, vice-president of operations with Harmony Healthcare International, a long term care consulting firm; and Holly Harris, an elder law attorney.
The case of Jimmo v. Sebelius reversed the long held interpretation that a patient must be making rehabilitative improvements in order to meet skilled criteria and be eligible for Medicare coverage. The regulatory clarification provides that Medicare will cover skilled nursing and therapy services when necessary to maintain a person’s condition, as well as, prevent or slow deterioration.
“For our patients needing continued rehabilitation services to prevent serious complications, the Jimmo v. Sebelius outcome was welcomed news,” says Nancy Zappolo, director of referral and case management for Welch Healthcare and Retirement Group.
Zappolo also said that recognizing the difference between observation and inpatient status is an important distinction for seniors to understand. ‘Hospital observation status’, defined by the Centers for Medicare & Medicaid Services, refers to the classification of hospital patients as ‘outpatients.’ And just like hospital inpatients, observation patients may stay for several days and nights in a hospital bed. However, absent of meeting the necessary three-day inpatient hospital stay, observation patients do not qualify for Medicare coverage for a subsequent skilled nursing facility stay.
The Village at Duxbury is the South Shore’s only continuing care senior living community from Boston to Cape Cod. The Village is managed by Welch Healthcare and Retirement Group, the leader in senior housing and services on the South Shore for over 65-years. For more information about the exceptional independent living apartments and single family Garden Homes, visit: http://www.villageatduxbury.com
For more information on Welch Healthcare and Retirement Group visit: http://www.welchrg.com