Eliminating '3-day stay' rule doesn't increase SNF admissions: study

Specially trained RNs could help reduce avoidable hospitalizations, results suggest.
Specially trained RNs could help reduce avoidable hospitalizations, results suggest.

Skilled nursing facility admissions don't increase when Medicare Advantage plans waive the three-day stay rule, new research asserts. The study also found SNF lengths of stay don't increase with the rule eliminated.

Researchers from Brown University compared hospital and SNF use among Medicare Advantage enrollees in plans that kept the three-day stay requirement against those that did not. The study analyzed data collected between 2006 and 2010. Investigators found that eliminating the three-day requirement resulted in a 10% decrease in hospital stay lengths, but had no association with rehospitalizations or SNF admissions, or with longer SNF stays.

One of the reasons behind the study was to determine whether a three-day stay requirement “still makes sense in 2015,” Amal Trivedi, M.D., an associate professor at Brown University's Department of Health Services, Policy and Practice, told McKnight's.

“To our knowledge the last time it was studied was in 1988 when the three-day stay policy was briefly eliminated for one year,” Trivedi said. “A lot has changed in healthcare over the past 25 years.”

The results of the study suggest eliminating the three-day stay requirement could help patients avoid “inappropriately” long acute hospital stays, and save money on “avoidable” hospital care, the authors wrote. Researchers also suggested that a study into the requirement's effects on traditional Medicare plans is warranted.

The cohort of Medicare Advantage beneficiaries whose data was analyzed as part of the study included “relatively few” long-stay nursing home residents, according to Trivedi. He back a specific study to examine how waiving the three-day stay rule would directly impact nursing homes.