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In This Issue

When Ten Cents per Page Can Cost You Thousands - Charging Residents for Records Under OBRA Can Waive Medical Liens Permitted Under N.C. Law
Most nursing facility providers know that under the OBRA federal regulations at 42 CFR 483.10(b)(2)(ii), a resident or his/her legal representative has the right to request a copy of the resident’s entire clinical record. The facility must provide these documents within two working days, but the regulation expressly allows the facility to charge the “community standard” rate for the cost of copying the records...

Challenging the Length of Immediate Jeopardy in Survey Appeals and IDR
Over the years, there has been a lot of discussion at CMS about what a provider can challenge in a formal survey appeal and, as a result, in the informal dispute resolution (IDR) that comes before a formal appeal. Under the federal regulations governing appeals, a provider may challenge any deficiency, but may challenge the scope and severity of a deficiency only if it rises to the level of immediate jeopardy (IJ) or constitutes substandard quality of care (SQC)...

Drought Threatens Nicaraguan Elders — Join Me and Adopt a Granny or Poppy
I just got word that a severe drought in western Nicaragua has brought new hardships to elders, particularly to those living in the hogares like the one we helped renovate in Jinotepe. In these rural areas, the drought means one thing — food shortages...
 
Ken’s Quote of the Month
“Do not go where the path leads. Go instead where there is no path and leave a trail.”  - Anonymous