News, Skilled Nursing Facility

25 national organizations join AHCA in letter to CMS regarding observation stays

On June 20, 2017, a broad coalition of beneficiary and provider advocacy groups submitted a comment letter to the Centers for Medicare & Medicaid Services (CMS) in response to the matter of observation stays in hospitals, an ongoing issue that prevents thousands of beneficiaries from being able to access their skilled nursing benefit because of this administrative classification.

Members of the group who signed the letter to CMS—which contains 25 national organizations, including AHCA—stated that they are dedicated to preserving Medicare beneficiaries’ access to necessary skilled nursing care following a hospital stay.

The letter goes on to provide a legal argument showing that CMS already has the authority necessary to implement the solution to the observation stay issue, explaining that CMS has exercised their authority to define “inpatient” care in certain areas of the Medicare program, and that they should do so in the case of observation stays as well by clarifying that any hospital stay classification, whether inpatient or outpatient, should be counted toward satisfying the SNF 3-day rule for purposes of ensuring Medicare coverage for necessary skilled services.