📁MFRR #030B — A Ruling That Should Have Changed Everything @CMAorg @wassdoc In 2013, a lawsuit changed what Medicare is legally required to cover. The case was Jimmo v. Sebelius. For years, care had been denied under a false rule: if a patient wasn't improving, Medicare wouldn't pay. Families were told "there's nothing more we can do," when the truth was "there's nothing more that will make them better" — as if those were the same thing. The court said they aren't. Maintaining someone. Slowing decline. Preventing a fall, a wound, a loss of function from getting worse — that is skilled, coverable care. A physician warned in 2017, writing about culture change, that as facilities took on sicker patients for better margins, enthusiasm for person-centered, maintenance-focused care quietly declined. COVID proved him right at a scale no one wanted. So we're left with a quiet contradiction. The law says maintaining someone counts. The money says declining is what gets funded. If a facility or a Medicare denial ever cites "no improvement" as the reason care is being cut, that is the exact argument this case struck down. Ask what Jimmo means for your loved one's care before you accept "nothing more we can do." A ruling that says maintenance matters means little if the system funding it still says otherwise. #MossFiles Ask Better Questions.

Many facilities and even some state rules fall well below these thresholds.Shift length (8 vs 12 hours) interacts with these ratios — fatigue from longer shifts can undermine even “adequate” numbers. Thoughts on balancing staffing minimums with sustainable schedules? Read more: chcs.org/what-to-know-about-… #EvidenceBasedCare #NursingHomes @NYNHCARE @MarthaDeaver1 @GeroAmericano @CMAorg @mtaylorstark