Observation Stay–Changes Coming?

Angie Szumlinski Uncategorized

Many times residents are transferred to an acute care setting for evaluation and treatment for conditions skilled nursing facilities are not be equipped to manage.  Unfortunately, many times residents are placed in an “observation” mode and not actually admitted to the acute care facility.  Although the resident is receiving appropriate care and being evaluated and monitored, they are not accruing actual inpatient days which would qualify them for Part A coverage when they return to the skilled nursing facility.

Recently, a new bill “Improving Access to Medicare Coverage Act of 2011” was introduced in the Senate (John Kerry, D-Mass and Olympia Snowe, R-Maine) and House (Joe Courtney, D-Connecticut and Tom Latham, R-Iowa).  The act seeks to recognize the fact that residents are often kept much longer than the prescribed limit for observation stays and are not informed of their admission status.  When the resident is discharged back to the skilled nursing facility or sent for initial placement, they do not qualify for Part A coverage. 

Many residents are not in a position  to pay out of pocket for skilled nursing services and will choose to return to the community with little or no support.  This bill “Improving Access to Medicare Coverage Act of 2011” is intended ensure that residents receive the full coverage they deserve.  Stay tuned, this is one bill we should all be keeping an eye on!