Help Available for Quality of Care Complaints
By: States: New York Source: AARP.org Date Posted: 2008-01-17 14:02:10.725721-05:00
As a Medicare beneficiary—or family member of a beneficiary—you may have concerns about the quality of medical care received in a hospital, nursing home, home health agency, hospice, outpatient facility or physician's office. If you have experienced a quality of care issue, it is important to alert an organization called IPRO, a not-for-profit organization that reviews these types of concerns and works with providers to improve care for future patients.
Improving the quality of care in New York State is becoming more and more important as the population ages and more New Yorkers become Medicare eligible. The IPRO review process helps ensure that the level of care received by Medicare beneficiaries, now and in the future, meets approved standards.
In 2005, New York had the third highest nursing home occupancy rate in the country. These numbers are not likely to decline as the elderly population is expected to increase dramatically in the next decade. New York's population that is 85 and older—the populations most likely to need long-term care—is projected to increase by 27% between now and 2020.
Although this review process is available to all of the 2.8 million Medicare beneficiaries in New York State, only a small fraction ever take advantage of it-simply because they aren't aware it exists. IPRO, the federally-funded Medicare Quality Improvement Organization for New York State, has been asked by the U.S. Centers for Medicare & Medicaid (CMS) to increase awareness of the Medicare quality of care review process.
Whether it's for you or someone you care about, the medical experts at IPRO will conduct an impartial review to determine if care met professional standards and will keep you updated on the progress of the case from start to finish. There is no cost for this service.
Here are some examples of quality of care complaints:
-Being given the wrong medication
-Not receiving treatment after abnormal test results
-Receiving the wrong blood type during a transfusion
-Sustaining a serious injury resulting from a fall while in a nursing home or hospital
-Receiving the wrong treatment or unnecessary treatment
-Developing bed sores as a result of not being moved regularly
To speak to a nurse case manager about a quality of care concern, call 1-866-491-4682. For more information on Medicare beneficiary rights and the concern review process, go online.
preview