Dec 21 2017
Washington, D.C. – Today Congressman Renacci reintroduced H.R. 4701, the Creating Access to Rehabilitation for Every Senior (CARES) Act. This bipartisan bill will reduce barriers to health care services for our nation’s seniors by eliminating the three-day inpatient hospital stay requirement for Medicare beneficiaries who are in need of skilled nursing facility (SNF) services. Eliminating the three-day stay requirement is supported by both hospitals and nursing homes throughout the country.
“The Creating Access to Rehabilitation for Every Senior (CARES) Act will enhance access to quality care for our nation’s seniors by protecting the doctor-patient relationship and removing Washington red tape as a barrier to their health care,” said Rep. Jim Renacci. “Beneficiaries in need of skilled nursing care are typically the frailest and oldest of the Medicare population, and they should not be shut out of these critical rehabilitation services due to Washington over-regulation. As a former operator and manager of long-term care facilities in Northeast Ohio, I remain committed to finding bipartisan solutions that will allow Ohio seniors to receive the treatment they need at the time they need it – without Washington standing in the way.”
- Enacted in 1965 by Congress, in order to meet Medicare criteria for coverage of post-acute care in a skilled nursing facility (SNF), patients must first have an inpatient hospital stay of three or more consecutive days, not counting the day of discharge.
- Medicare covers up to 100 days of SNF care per episode of care…but there’s a catch… following a qualifying three-day inpatient hospital stay.
- In July 2013, the Office of the Inspector General (OIG) reported that beneficiaries had 617,702 hospital stays that lasted at least three nights, but did not include three inpatient nights; these beneficiaries did not qualify for SNF services under Medicare. The OIG report concluded that CMS should consider how to ensure that beneficiaries with similar post-hospital care needs have the same access to and cost-sharing for SNF services.
- In September 2013, the Commission on Long-Term Care called for the enactment of legislation to eliminate the requirement of a prior three-day inpatient stays in an SNF. The Commission noted that with declining hospital lengths of stay, many inpatient stays that require post-acute skilled nursing may not qualify for coverage. The Commission report also included the fact that without the three-day inpatient stay, patients who should be transferred for a short post-acute stay in a SNF would not be eligible for coverage.
This legislation not only better serves patients with more accurately designated care, but also reduces costs to our already stressed healthcare system by relying less on the expensive inpatient hospital setting, and shifting the weight more towards patient-centered care settings such as in an SNF.