Observation stay bills in focus for LTC providers

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Nonprofit long-term care providers continued to focus on bills related to observation stays during visits on Capitol Hill Tuesday.

Providers were encouraged to drum up support and co-sponsors for the bills in question, HR 1179 and SB 569, which would count all the time a Medicare beneficiary spends in the hospital toward meeting the 3-day inpatient requirement for subsequent skilled nursing care. Currently, many seniors are placed in observation status, sometimes for many days, and this does not count toward the inpatient requirement.

“The Senate bill and the House bill give transparency and say if there is a head in a bed that counts,” said Cheryl Phillips, M.D., senior vice president of advocacy at LeadingAge. She spoke during the morning's briefing with hundreds of providers in Washington, D.C. for the LeadingAge Peak event.

Phillips noted that there have been numerous observation stay bills recently, including one to completely eliminate the 3-day inpatient requirement. Phillips and LeadingAge President and CEO Larry Minnix encouraged members to stay focused on the plan that is most practical.

“This is a no-brainer to fix,” Minnix told McKnight's. “It benefits consumers and providers, and it's [currently] a screwy policy. Let's fix it now.”

While some have argued that CMS's recently enacted two-midnight rule should fix much of the problem for seniors, providers counter that it doesn't help those who are in the hospital for fewer than two midnights and may face huge costs when they discover they are ineligible for skilled nursing care.

“It's a very important issue for us, and it gets into the weeds very quickly,” noted Michele Kent, LeadingAge New Jersey president and CEO. “Seniors often think that because they are in the hospital, they're covered. It's complicated.”

Other talking points during Hill visits included repealing therapy caps, affordable housing, the "doc fix" and no more across-the-board reimbursement cuts.

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