At least some hospital advocates praised the new bill, which was quietly introduced Tuesday by Sen. Pat Roberts (R-Kan.).
“Eliminating the 25% rule will ensure that patients are not prohibited arbitrarily from receiving needed care” in long-term-care hospitals, Richard Umbdenstock, president and CEO of the American Hospital Association (PDF), said in a news release. “This bill will replace blunt payment policies with comprehensive clinical criteria to ensure that LTCHs uniformly serve high-acuity patients. This will allow LTCHs to focus on their mission of caring for very sick patients who need intensive care for a long period of time.”
In addition, the legislation would create specific requirements for patient preadmission, admission, continued stay and discharge. The measure also would specify long-term-care hospitals' “core services” and patient-care requirements, such as physician availability, according to the legislation.
The measure would require that a minimum percentage of annual discharges fit at least one of the following categories: patients for at least 25 days; a short-term acute-care hospital outlier immediately prior to admission to the LTAC; an inpatient who received ventilator services in the LTAC; or a patient who has at least three major complications and co-morbidities. Failure to meet that standard would result in a probationary period, followed by rate cuts.