Medi- Minutes

Financial Screening Affects 
Medicaid Beneficiaries’ Nursing Home Access

A recent report by the Office of the Inspector General (OIG) shows that financial screenings by nursing homes conducted as part of their admissions process have a negative impact on access for Medicaid beneficiaries.

Facilities can request financial information from beneficiaries as part of their admissions process and can designate a distinct part by certifying a specific number of their beds for Medicare and/or Medicaid. In recent years the Health Care Financing Administration (HCFA) and the Office of Civil Rights (OCR) have been alerted by nursing home advocacy groups and beneficiaries that nursing homes may be using financial screening and distinct part rules to limit access for Medicare and Medicaid applicants.

The OIG determined that, overall, distinct part rules do not appear to limit access for Medicaid or Medicare beneficiaries. However, financial screening negatively impacts access primarily for Medicaid beneficiaries. While no Medicaid officials and only eight ombudsmen report that Medicaid beneficiaries are "very often" denied access to a nursing home because of financial screening, one-third of discharge planners say that nursing homes refuse patients "very often" for financial reasons.