Medicare Coverage

Determining medically necessary Medicare coverage

Determining medically necessary Medicare coverage

Accurate and thorough nursing documentation is the crucial factor in determining medical necessity. As nursing leaders in long-term care, we are obligated to ensure that Medicare documentation standards meet the premise of reasonable and necessary care and services.

Oral health's integral role in long-term care quality

Oral health's integral role in long-term care quality

While easy and relatively quick actions can reduce the severity of oral health issues developing over time, they are some of the most challenging activities to consistently attend to in many managed care settings.

Bill addressing admission status receives praise

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A bill that would require hospitals to give patients a formal notice of their admission status has received strong support from healthcare associations.

Medicare coverage of 'maintenance therapy' determined by need for skilled care, CMS clarifies in Jimmo document

Medicare coverage of 'maintenance therapy' determined by need for skilled care, CMS clarifies in Jimmo document

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Providers must sufficiently document the need for skilled care in order to obtain Medicare coverage for so-called "maintenance therapy," the Centers for Medicare & Medicaid Services stressed in a recent fact sheet on the Jimmo v. Sebelius settlement agreement.