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DOCURENT RESUME
63493 - [A2553675]
[Review of Complaints Which Caused Three Nursing Homes to
Withdraw from the Medicare Program]. HRD-77-137; B-164031(4).
September 9, 1977. Released September 12, 1977. 7 pp.
Report to Sen. Strom Thurmond; by Elmer B. Staats, Comptroller
General.
Issue Area: Health Programs: Compliance With Financing Laws and
Fegulaticns (1207).
Contact: A.uian Resources Div.
budget Function: Health: Health Care Services (551).
Organization Concerned: Blue Cross of South Carolina; Blue
Shield cf South Carolina; Department of Health, Education,
and Welfare; Social Security Administration.
Congressional Relevance: Sen. Strcm Thrrmond.
Authority: Social Security Act.
Coaplaints made by three nursing homes in South
Carclina involved many of the same issues which have caused
cther nursing homes to withdraw from the Med~care program in the
past. The most important criticism of the prograw +1hAt
Medicare's payment of services already provided may be denied if
the intermediary determines that the services were not medically
necessary. This problem can only be eliminated by liberalizing
Medicar(.vs law and regulations. Findings/Conclusions: The
Honorage Nursing Center and the Commander Nursing Home in
Florence, South Carolina, and the Hampton Nursing Center in
Sumter, South Carolina, all complained of the large amount of
paperwork required by the Medicare program. A cursory review of
the forms and documents required showed the paperwork to be
voluminous and freqnent, but nece-sary to control of the
program. The nursing homes also complained that the Medicare
guidelines do not allow for adequate compensation of the
cwner-administrator of the homes. The amount of money not
allowed due to limitations on compensating the
owner-administratcr does not seem significant, since the
administratcr's salaries are a small part of the nursing homes'
total cost. .I11 three of the hcmes complained of the uncertainty
of the intermediary's decisions with regard to the necessity of
the medical services and the level of care provided and of the
possible financial losses which could result from losing their
waivers of liability. (SC)](ViewImageLocal?handle=hein.gao/gaobaacqq0001&div=1&collection=&method=preview&ext=.png&size=3)