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August 29, 2017

OIG Investigation Finds Nursing Home Abuse Often Not Reported

The Department of Health and Human Services Office of Inspector General (OIG) released an early alert on Monday about potential abuse or neglect at skilled nursing facilities (SNFs). OIG's investigation has found that more than one-quarter of serious cases of nursing home abuse are not reported to law enforcement, despite state and federal law requiring it.  OIG is conducting an ongoing review into nursing home neglect and abuse, and their early alert was issued in order to prompt immediate actions to ensure better protection of individuals in SNFs.  The investigation reviewed records from 2015 and 2016 and found 134 cases of abuse severe enough to require emergency treatment; 28% of these cases were not reported to the police.  The alert determined that CMS has inadequate procedures to ensure that incidents of potential abuse are identified and reported, and it suggests immediate actions for CMS to protect vulnerable residents in SNFs.  Read the alert here.

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Justice in Aging Issue Brief on Preventing Evictions When Implementing Federal HCBS Regulations

Justice in Aging has released a new issue brief that discusses how states whould implement the new federal Home and Community-Based Services (HCBS) regulations in order to prevent improper evictions.  In 2014, CMS released regulations that set standards for HCBS settings, and in order to implement the regulations, states must have a transition plan approved by CMS by March 2019.  One requirement of the new regulations requires states establish eviction protections for individuals living in residential HCBS settings like assisted living facilities or group homes.  Many states' proposed transition plans would not do enough to protect HCBS consumers.  Justice in Aging's issue brief examines state proposals, explains why many states' plans are inadequate, and offers recommendations on best practices to prevent improper evictions.  Read the brief here.

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CMS Launches Jimmo Settlement Agreement Webpage

CMS has launched a new webpage on the Jimmo Settlement Agreement.   The Jimmo Settlement agreement clarified that the Medicare program covers skilled nursing care and skilled therapy services when a beneficiary needs skilled care in order to maintain function or to prevent or slow decline.  Specifically, the Jimmo Settlement requried manual revisions to restate a "maintenance coverage standard" for both skilled nursing and therapy services.  The Jimmo Settlement may reflect a change in practcie for those providers or others who have erroneously believed that the Medicare program covers nursing and therapy services only when a beneficiary is expected to improve.  The new Jimmo Settlement Webpage provides background on the settlement, links to resources and Frequently Asked Questions.  Access the webpage here.

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State of Iowa Asks CMS to Waive Retroactive Medicaid Eligibility

A proposal in Iowa would waive retroactive Medicaid eligibility, an essential protection for the Iowa Medicaid program.  Medicaid law allows for eligibility up to three months prior to the month of application if the person met eligibility requirements during the months in question.  The retroactive coverage protects individuals when unexpected health care needs arise.  The State of Iowa has asked CMS to waive this protection, putting hundreds of low-income Iowans at risk.  Plus, many other states may follow suit if CMS approves Iowa's request, putting thousands of other individuals at risk nationwide.  Submit comments about Iowa's waiver request here ("Answer the Questionnaire").  Justice in Aging has prepared sample comments which can be adapted for your submission.  Comments are due September 7.

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Spotlight on Resources

The Consumer Voice and the National Ombudsman Resource Center (NORC) have a multitude of resources available online covering a wide range of long-term care topics.  Visit the Consumer Voice website and the NORC website to explore all the available resources.  Take a look at this week's highlighted resource:

Abuse, Neglect and Exploitation in Long-Term Care Facilities - This NORC issue page provides information on several forms of abuse and includes useful links to further resources.

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In this Issue

OIG Investigation Finds Nursing Home Abuse Often Not Reported

Justice in Aging Issue Brief on Preventing Evictions When Implementing Federal HCBS Regulations

CMS Launches Jimmo Settlement Agreement Webpage

State of Iowa Asks CMS to Waive Retroactive Medicaid Eligibility


Spotlight on Resources


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