CLINICAL/CE WEBINAR

Advocating for Clients in Skilled Nursing Facilities:
How the Medicare "Maintenance Standard" Applies

Thursday, March 19, 2020

4:00 pm ET, 3:00 pm CT, 2:00 pm MT, 1:00 pm PT

Registration deadline: March 12, 2020

Sponsored by

Aging Life Care Professionals® are advocates for the rights of their clients in skilled nursing settings, but it can be difficult to get your client the services they need and are entitled to. How often have you heard from skilled nursing facility staff that your client must be discharged because they aren't making progress? Have you heard the word "the patient has plateaued" one time too many? 

In 2011 six aggrieved Medicare recipients joined seven national advocacy organizations to allege that the Centers for Medicare and Medicaid Services (CMS) routinely and systematically deprived beneficiaries of skilled care The seminal "Jimmo" class action case triggered an ongoing saga that has been likened to a Dickens novel. In sum, the Jimmo plaintiffs alleged that CMS contractors and adjudicators improperly based skilled services authorizations on an “Improvement Standard” rather than the appropriate “Maintenance Standard.” 

Despite the court’s ultimate approval of a settlement agreement, and subsequent enforcement litigation, nine years later, the pervasive use of the “Improvement Standard” persists. Medicare contractors continue to deny skilled care on the basis that a patient has not demonstrated functional improvement (they have "plateaued") or has a medical condition that inhibits progress.

To effectively advocate for our clients and secure those coveted “100 days” of SNF coverage, we must understand the application of the Maintenance Standard in the nursing home setting. This webinar will explore the scope of coverage and will provide specific advocacy tips for Aging Life Care Managers. Moriah Adamo will inform participants with the governing Medicare rules and standards so they can assist their Medicare beneficiary clients maximize their rehabilitation services. 

Learning Objectives:

• Understand the Jimmo v. Sebelius court case and how it affects people receiving skilled nursing services 
• Describe the services covered under Medicare Part A in skilled nursing settings
• Learn how to respond when staff inform your client, they must be discharged due to non-improvement/"plateauing"
• Help your client navigate the appeal process 

About the Presenter

Moriah Adamo is a Partner at Abrams, Fensterman, Fensterman, Eisman, Formato, Ferrara, Wolf & Carone,LLP. Ms. Adamo manages the Firm’s Elder Law Practice in our Lake Success office.  She distinguishes herself as a litigator in the context of Medicaid and Article 81 Guardianship proceedings. 

Ms. Adamo represents clients through all phases of maximizing governmental benefits from planning through appeals. Regularly prosecuting all stages of Medicare and Medicaid appeals, including preparing and advocating for appellants at Fair Hearings and Article 78 proceedings, provides Ms. Adamo with unique experience.  She applies that knowledge to assist families planning for and experiencing long term health care needs. Ms. Adamo has successfully represented clients to secure and maximize increased rehabilitation and home care hours, reverse penalty periods, and eliminate findings of excess resources. State and Federal Courts have certified Ms. Adamo as an expert witness in the substantive area of Medicaid in civil and criminal matters.

In the Guardianship proceedings, Ms. Adamo marries litigation skills with extensive knowledge of Medicaid to achieve pragmatic results for incapacitated individuals.  Not only has she represented litigants in both contested and uncontested proceedings, but she regularly receives judicial appointments to serve as counsel to alleged incapacitated persons and guardians.

Ms. Adamo is a frequent lecturer on the various Medicaid, Guardianship and estate planning topics. Ms. Adamo has authored published articles examining various issues involving maximization of Medicaid benefits.  Ms. Adamo has lobbied the State Legislatures regarding important Medicaid programs, advocating for protection of disabled New Yorkers. She is the chair of the community relations and public education committee at the Nassau County Bar Association. She is the former co-chair of the Nassau County Bar Association’s Elder Law, Social Services & Health Advocacy Committee. In addition, she serves as co-chair of the New York State Bar Association's Elder Law and Special Needs Section's Health Law Committee.

Prior to joining Abrams Fensterman, Ms. Adamo was an associate at a boutique long island elder law firm.  Ms. Adamo graduated from Arizona State University, manga cum laude, and Touro Law School, summa cum laude. At Touro Law School, Ms. Adamo was a faculty fellow, recipient of a judicial clerkship fellowship, a merit scholar, and a member of the moot court team.  Ms. Adamo has been selected as a "Rising Star" in New York Elder Law by "Super Lawyers" since 2014. Each year, no more than 2.5% of the lawyers in the state are selected by the research team at Super Lawyers to receive this honor.

Continuing Education Credit Hours

ALCA has been approved for 1 CE contact hour from CBRN, NACCM, and NYSED, and has applied for approval from NASW and CCMC. Provider approved by the California Board of Registered Nursing, Provider # 15884, for 1 Contact Hour. Aging Life Care Association, SW CPE is recognized by the New York State Education Department's State Board for Social Work as an approved provider of continuing education for licensed social workers #0166. This event has been approved for 1.0 contact hour. Attendee must attend entire webinar to receive any CE certificates. Attendees requesting a CE Certificate for Social Work (NASW or NYSED) must successfully submit and pass a post-test prior to receiving CE certificate.

Cancellation Policy

The registration fee for webinars is non-refundable. Registrants who are not able to attend the webinar will receive audio & video files following the event. For clinical webinars, CE contact hours will not be available to those who are not able to attend the entire live event.

In the unfortunate event that a webinar needs to be cancelled or rescheduled ALCA will notify the registrant by email and provide information on the new date or alternative arrangements. If the registrant is not able to attend the new date ALCA will refund the registration fee or place a credit towards a future event. 

Fees:    Free for Advanced Professional Members

            $29.00 for Members and Corporate Partners / $99 for Nonmembers