Bipartisan legislation introduced in both Houses of Congress today would remedy the complex and confusing process resulting from observation status during a hospital stay. Introduced by Senators John Kerry (D-MA) and Olympia Snowe (R-ME) along with Representatives Joe Courtney (D-CT) and Tom Latham (R-IA), the Improving Access to Medicare Coverage Act of 2011 would rectify a confusing status that leaves seniors in a limbo land of healthcare delivery. The bill ensures that time spent under observation status in a hospital to count toward satisfying the 3-day inpatient hospital requirement for coverage of skilled nursing facility services under Medicare.
Often patients are kept much longer than the prescribed limit for observation stays and are not informed of their admission status. In fact, from 2007-2009 the number of patients spending four or more days under observation status doubled.
Patients who need to enter a skilled nursing facility following an observation stay face the possibility that their care in the facility will not be covered by Medicare Part A because of the lack of hospital classification as an inpatient. This can result in patient confusion and the possibility of not receiving appropriate and necessary skilled nursing care. In some instances, patients arrive at a nursing facility, and because Medicare will not cover the benefit they are forced to pay out-of-pocket.
“There is a growing trend harming seniors who need critical skilled nursing care following a hospital stay that often leaves them in a no-mans land,” stated Governor Mark Parkinson, President and CEO of American Health Care Association, FHCA's national affiliate. “Sens. Kerry and Snowe and Reps. Courtney and Latham recognize this problem and how deep it runs, and we applaud their efforts ensuring that we can not ask the elderly and frail to pay with his or her health. The post-acute care profession is eager to work with our Congressional champions, hospitals, physicians and CMS to ensure that beneficiaries are not deprived of necessary and appropriate Medicare-covered post-acute care because of lengthy observation stays.”