ElderWeb

In recent years, the Health Care Financing Administration (HCFA) and the Office of Civil Rights (OCR) have been alerted by nursing home advocacy groups and beneficiaries that nursing homes may be using financial screening and distinct part rules to limit access for Medicare and Medicaid applicants. Facilities can request financial information from beneficiaries as part of their admissions process and can designate a distinct part by certifying a specific number of their beds for Medicare and/or Medicaid. There is some concern, however, that facilities are using these practices to deny access to Medicare and Medicaid beneficiaries. The Health and Human Services Agency Office of the Inspector General (OIG) investigated this issue, and released a new report, "The Effect of Financial Screening and Distinct Part Rules on Access to Nursing Facilities."

They reported that, overall, distinct part rules do not appear to limit access for Medicaid or Medicare beneficiaries, but they did find access problems related to requests for financial information for Medicaid beneficiaries. Ombudsmen, Medicaid officials, and nursing home administrators report that facilities commonly ask for financial information, often about a person?s assets, income, and insurance. When financial screening occurs, it primarily affects access for Medicaid beneficiaries. While no Medicaid officials and only eight ombudsmen report that Medicaid beneficiaries are "very often" denied access to a nursing home because of financial screening, one-third of discharge planners say that nursing homes refuse patients "very often" for financial reasons. Many discharge planners note that Medicaid patients are most likely to be affected by these practices.