New Schumer Bill Helps Vulnerable Nursing Home Patients by Addressing Unfair, Costly Hospital "Observation Stays"

AQNHC: "Improving Access to Medicare Coverage Act" Also Helps Encourage Use of Skilled Nursing Facilities (SNFs) as Lowest Cost Setting Appropriate to Beneficiary Need

Feb 25, 2013, 12:40 ET from Alliance for Quality Nursing Home Care

WASHINGTON, Feb. 25, 2013 /PRNewswire/ -- The Alliance for Quality Nursing Home Care (AQNHC) today 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 help ensure vulnerable nursing home patients have access to necessary Medicare-covered skilled nursing care after being hospitalized.

"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 of the Alliance for Quality Nursing Home Care. "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. Further, encouraging the use of skilled nursing facilities as the lowest cost setting appropriate to beneficiary need is sound, timely policy." Rosenbloom said AQNHC -- a coalition of 10 leading post-acute and long term care organizations providing skilled nursing facility (SNF) care in approximately 1,200 facilities, in 44 states nationwide -- will work to help pass this legislation.  



Rebecca Reid



SOURCE Alliance for Quality Nursing Home Care