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LTC group praises bill addressing hospital observation stays

February 26, 2013
by Patricia Sheehan, Editor-in-Chief
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The Alliance for Quality Nursing Home Care (AQNHC) on Monday praised the introduction of New York Senator Chuck Schumer's (D-NY) bill, the Improving Access to Medicare Coverage Act, which changes Medicare law to permit nursing home residents access to skilled nursing care after hospital “observation stays.”

"The practice of admitting hospital patients for 'observation' has expanded greatly in recent years to the point where patients can stay in hospitals for several days without actually being officially admitted," said Alan G. Rosenbloom, president, AQNHC, in a statement. "That has significant, negative financial consequences for patients if they require follow-on SNF care, as they have not 'officially' met Medicare's three day prior hospital stay rule."

Medicare currently only covers post-acute care in a SNF if a patient has three consecutive days of hospitalization as an inpatient. The Improving Access to Medicare Coverage Act would allow so-called "observation stays" to be counted toward the three-day mandatory inpatient stay for Medicare to cover rehabilitation post-hospital SNF admission. Observation stays are specific, clinically appropriate services that treat and assess a patient in a hospital while a decision is being made as to whether patients will require further treatment as hospital inpatients—or if they can be discharged from the hospital.

"Senator Schumer's legislation is in precise alignment with AQNHC's push for systemic reforms that better rationalize the post-acute payment system for the collective benefit of patients, providers and taxpayers, Rosenbloom said. “Further, encouraging the use of skilled nursing facilities as the lowest cost setting appropriate to beneficiary need is sound, timely policy."

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