The American Health Care Association argued to the CMS that all of a patient's days in a hospital—including days spent on observation status—should count toward a Medicare three-day minimum before the patient qualifies for Medicare skilled-nursing care, in a comment letter on a proposed CMS rule released in July.
AHCA weighs in on three-day minimum
Currently, in order to receive Medicare coverage at an SNF, patients must be admitted to a hospital as an inpatient for at least three days, according to a news release from AHCA, which represents nursing homes. “Even though CMS acknowledges the serious consequences of prolonged observation stays, CMS has not acted to mitigate them and has chosen to (forgo) multiple opportunities to address the problems,” wrote Elise Smith, senior vice president of finance policy and legal affairs (PDF), in the letter to acting CMS Administrator Marilyn Tavenner, in reference to that and other issues raised in the letter.
Smith also recommended that a serious examination of the appropriateness of the three-day requirement be undertaken.
“We are very appreciative of the renewed interest that CMS has taken in the plight of beneficiaries denied Medicare coverage of post-acute care because the time they spent in the hospital was in an observation stay,” Smith wrote.
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