Long-term care leaders criticize Washington Post article on reimbursements

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Alan Rosenbloom, president of the Alliance for Quality Nursing Home Care
Alan Rosenbloom, president of the Alliance for Quality Nursing Home Care

A recent Washington Post analysis of the use of “ultra-high” reimbursement categories for nursing homes “paints a negative, incomplete picture of the growing role and tangible benefits associated with skilled nursing facility (SNF) patient care,” two leading long-term care advocates said.

In a letter to McKnight's (see letter attached), Alan G. Rosenbloom, President of the Alliance for Quality Nursing Home Care, and Bruce Yarwood, President and CEO of the American Health Care Association, denounced the Post article as “irresponsible and inaccurate.”

“The headline and premise of the story itself suggests so-called ‘up coding' is somehow a standard means of over-billing Medicare,” the two leaders wrote. “Facilities must use specific regulatory tools to provide patient assessment, which then reflects the level of reimbursement. Any suggestion that facilities are able to bill any way that they wish are simply false and misguided.”

The Washington Post piece, titled, “Review Heightens Concerns Over Medicare Billing at Nursing Homes,” focuses on some skilled nursing providers who classify up to 65% of their patients in the “ultra-high” billing category. The Post analysis alleges that this practice constitutes a misuse of Medicare funds and costs up to $2 billion each year. (McKnight's, 3/30/10)

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