Medicare has terminated its agreement with the Aventura at Terrace View nursing home in Blakely, according to a legal notice posted by the Center for Medicare & Medicaid Services.
The notice says that as of Wednesday, the skilled nursing facility at 260 Terrace Drive is no longer a participant in the Medicare program “due to the facility’s failure to meet Medicare’s basic health and safety requirements.”
Aventura’s agreement as a nursing facility in the Medicaid program was also terminated effective Wednesday.
The notice says Aventura was notified that Medicare will cease paying for services furnished to Medicare and Medicaid beneficiaries admitted after last Oct. 24, although payment may continue for up to 30 days for patients admitted on or before that date.
Attempts to reach the Blakely facility were unsuccessful.
“We are closely monitoring the relocation of Medicare and Medicaid patients to other facilities,” the legal notice says. “CMS requires facilities to meet certain health and safety standards to be certified as a Medicare provider. Mandatory termination of a provider agreement is generally a last resort after all other attempts to remedy the deficiencies at a facility have been exhausted.”
According to KFF, an independent source of health policy research, as of July 2024, Medicaid was the primary payer for 63% of nursing facility residents; Medicare for 13% of residents; and the remaining 24% of residents had another primary payer, such as private insurance or out-of-pocket.
The Center for Medicare & Medicaid Services recommends that residents, patients and their family members visit the following websites for assistance through the relocation process: Care Compare at https://www.medicare.gov/care-compare, and Pennsylvania Ombudsman at https://www.aging.pa.gov/aging-services/Pages/Ombudsman.aspx.
The legal notice is attributed to Heather A. Lang, director, Division of Northeast Survey & Enforcement, Survey and Operations Group, Center for Clinical Standards and Quality, Centers for Medicare & Medicaid Services.
Aventura at Terrace View was formerly the Lackawanna Health and Rehab Center. The facility’s website says it has 272 beds.
Medicare is the federal health care insurance program for people age 65 and over, and for the disabled. Eligibility is based mainly on eligibility for Social Security. Medicare helps pay charges for hospitalization, for stays in skilled nursing facilities, for physician’s charges and for some associated health costs.
Medicaid is the federal-state health care insurance program that helps pay for health care for low-income people of any age. Coverage varies by state; each state determines eligibility and the full scope of services covered. The federal government reimburses a percentage of the state’s expenditures.