Aging Health Matters

SUMMARY
As a contractor for Medicare, Acentra Health serves as the Beneficiary and Family Centered Care Quality Improvement Organization, also referred to as a BFCC-QIO. While Acentra Health provides BFCC-QIO services in 29 states, the general information is relevant to everyone who has Medicare (including Medicare Advantage) and everyone who works with people who have Medicare.

This episode is a conversation with our guest, Ed Guzmán, the Regional Ombudsman for the Olympic Washington region. He was born and raised in NYC and worked as a teacher. He eventually went to Southern California for graduate school in philosophy.

He has worked in advocacy for approximately three years. He spent one year as an Assistant Regional Ombudsman for the Olympic Region Long-Term Care Ombudsman Program. Since July 2023, he has served as the Regional Ombudsman for the Olympic Region. He is passionate about advocacy and empowering the self-determination of facility residents in Washington state.

In this podcast, Mr. Guzmán will share information about some of the differences between skilled nursing care and long-term care, how Medicare pays for skilled care, skilled service terminations with Acentra Health, and a successful reconsideration in his state.

For more information about Acentra Health BFCC-QIO, please visit www.acentraqio.com.

KEY TOPICS

00:29: Overview, introduction of guest, Ed Guzmán
02:22: Differences between skilled nursing and long-term care
04:54: Requirements for Medicare to pay for skilled care
07:23: Information about appealing a skilled service termination with Acentra Health
09:28: Successful reconsideration
12:19: Final thoughts

SUBSCRIBE

Subscribe to our newsletters: Case Review Connections, On the Healthcare Front

RESOURCES

BFCC-QIO Information for stakeholders: www.acentraqio.com/partners

BFCC-QIO Information for people who have Medicare: www.acentraqio.com/bene

Washington State Long-Term Care Ombudsman Program: https://www.waombudsman.org/

Acentra Health’s Skilled Service Appeal Information - https://acentraqio.com/bene/appeal.aspx

Music: Motivational Upbeat Corporate by RinkevichMusic https://soundcloud.com/rinkevichmusic
https://protunes.net/
Video Link: https://bit.ly/3NNqGTs