Some of California’s most vulnerable nursing home residents, many of whom have nowhere else to go, are receiving letters from their health care plans saying they are no longer eligible for long-term care. In one notable example, three dozen nursing home residents in San Luis Obispo County were informed on the same day that their […]

Last year, an investigation by The Dallas Morning News exposed how the giant companies Texas pays to provide health insurance to extremely poor and disabled people were systematically skimping on care to boost profits. Days after “Pain & Profit” began publishing, Texas lawmakers launched official inquiries, millions of dollars were freed up to increase state oversight and about two dozen bills […]

2017 marks the 30th anniversary of the passage of the Nursing Home Reform Act as part of the Omnibus Budget Reconciliation Act of 1987, the federal legislation that substantially strengthened federal standards, inspections and enforcement of nursing home quality. The Act also merged Medicare and Medicaid standards, required comprehensive assessments of residents, set minimal requirements for […]

Marcela Villa isn’t a big name in health care — but she played a crucial role in the lives of thousands of Medicaid patients in California. Her official title: denial nurse. Each week, dozens of requests for treatment landed on her desk after preliminary rejections. Her job, with the assistance of a part-time medical director, […]