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Memphis Nursing Home to Lose Medicare and Medicaid Reimbursement

A nursing home in Memphis, Tennessee, is losing patients and staff members as it is being cut off from Medicare and Medicaid reimbursement funding for patient services. The nursing home is Signature HealthCARE at St. Francis, which also has been fined over $1.2 million for failing to meet certain minimum standards. This nursing home received poor grades on multiple Medicare surveys, leading to an overall rating of two out of five stars.

Of the areas surveyed, the nursing home performed worst in health and fire safety inspections. In its most recent health inspection in September 2016, 15 health deficiencies were noted. This number was far above the average number of deficiencies for Tennessee facilities, 5.1. It is also more than two times the national average of 7.2.

Signature is a large nursing home chain. It is based in Louisville, Kentucky. Overall, Signature operates more than 120 nursing homes in the United States, including five in the Memphis area. According to reports, nursing home residents began to transfer to other facilities when news broke that Medicare and Medicaid would no longer be reimbursing the nursing home for services performed for the residents. As of March 2017, around half of the facility’s beds were not being used. This has prompted the nursing home to lay off staff members. The nursing home has said it will appeal the reimbursement decision.

Medicare and Medicaid provide essential services and health coverage to millions of disabled, elderly, and low income individuals throughout Tennessee and the United States. Skilled nursing care is often expensive, as patients may require around-the-clock care and supervision. Thus, many nursing home residents could not afford the services without assistance from some form of health insurance. With federal funds being involved, nursing homes are held to standards set forth by the federal government.

The Centers for Medicare and Medicaid Services (CMS) is one agency that inspects nursing homes and similar facilities to ensure compliance with relevant, minimum standards. Failure to comply with these standards could result in large fines and being cut off from receiving Medicare and Medicaid payments. Survey results are made available to the public so that people can make informed decisions before sending a loved one into a nursing home or long term care facility.

Nursing homes are given an overall rating between one and five stars, with a five star rating being the highest. Nursing homes are given separate ratings for the following categories:

  1. Health inspections – including data and results of recent site inspections either conducted as normally scheduled or in response to a complaint.
  2. Staffing – including how the facility ensures patients receive adequate supervision and treatment.
  3. Quality measures – a more comprehensive rating on the nursing home’s performance and how well a nursing home cares for its residents’ needs. This rating incorporates 11 different physical and clinical measures.

Nursing homes may face liability for a patient’s injuries for negligence or failure to meet licensing standards. These rules are put in place to optimize medical care and prevent rogue companies from blatantly placing profits over people. When a nursing home is only concerned about its bottom line, problems can result including inadequate staffing, lack of supervision, and improper medical care. All of these can directly lead to unnecessary injuries, which could mean a complication for a resident who already has one or more disabling medical conditions.