A Skilled Nursing News article highlights that during the peak of the COVID-19 pandemic, the Centers for Medicare & Medicaid Services administrator Seema Verna announced changes to the rules governing nursing homes including waiving the requirement of a three-day hospital visit for Medicare to cover an SNF stay. The goal of waiving this requirement was to reserve hospital beds for the most severely ill patients.
In a presentation by David Grabowski, a professor at Harvard Medical School said that “this was not a popular rule prior to the pandemic; it was obviously waived; I do think it was a good rule to waive and I think it’s been overall effective for the pandemic. However, I don’t think we’re going to see this waived in a post-pandemic world.” Grabowski went on to say, “I do think we’re going to go back to a three-day rule”.
There may be a positive to this according to Fred Bentley, managing director at the Washington, D.C. based consulting firm Avalere Health, in that since CMS is gathering data on the care during this time and could combine it with data from Next Generation accountable care organizations (ACOs) and other entities that can waive the three-day requirement, it will at least be assessing the outcomes of the rule being waived.
If you have an opportunity to voice your concern about reinstating the 3-day stay, jump on it, shout it from the rooftops, share this information with colleagues and stay well, stay safe, and stay tuned!