DLP Fights for Victims of Nursing Home Abuse and Neglect – McKnight’s Long-Term Care News Reports: “Cost, conversion of long-stay residents fuel resistance to 3-day stay waiver”

nursing home 3 day waiver
Date: April 28, 2023

According to McKnight’s Long-Term Care News, concerns have been deeply expressed by many after a new study published in JAMA Internal Medicine suggests that the elimination of a hospital stay requirement for nursing home residents covered under Medicare could result in an overflow of long-term residents receiving skilled care coverage.

Researchers analyzed a report from the Centers for Medicare and Medicaid Services, which indicated that the “three-day hospital stay waiver”, was intended to transfer patients with serious medical conditions covered under Medicaid to profitable “Medicare rolls”. This practice was commonly seen during the Covid-19 pandemic because many patients contracted Covid-19. However, skepticism arose when some non-COVID-19 patients were transferred as well.

Researchers studied approximately “4.3 million” skilled nursing facility recipients of “Medicare fee-for-service” from the beginning of 2018 to September 2021. They concluded that waiver usage or those lacking a prior short-term stay rose from “3%” in 2020 to “18%” in 2021. Furthermore, waiver usage among “long-term residents” greatly escalated from “4% to 49%, but Marselas reports that “62% of waiver usage among this group accounted for Covid-19 patients.” Yet, researchers have seen some suspicious waiver usage, especially for those with type 2 diabetes. Many residents with type 2 diabetes were transferred into “skilled care stays” even though they did not contract Covid-19.

The “three-day hospital stay waiver” abolished the rule that patients had to be in the hospital for three days before they received Part A coverage under Medicare. The waiver will go into effect on May 11, 2023. McKnight’s author, Kimberly Marselas, writes that members from the Congressional Budget Office are worried that removing this waiver could increase the cost of care in skilled nursing facilities by billions of dollars over only ten years. Additionally, this
rule could create an influx of new nursing home residents which can place further challenges to providing quality care to existing residents.

 Contact an Experienced Scranton Nursing Home Abuse and Neglect Attorney

Please check in with your family members or friends residing at their nursing home facility to make sure they are receiving the proper care that they deserve. If you or a loved one has been a victim of nursing home abuse and/or neglect, please reach out to our team of trial lawyers at Dougherty, Leventhal & Price, L.L.P. Our team will fight for you!!! Remember: Injury? Call DLP! (570) C-A-L-L-D-L-P.

Works Cited

Marselas, Kimberly. “Cost, conversion of long-stay residents fuel resistance to 3-day stay waiver.” McKnight’s Long-Term Care News, 26 April 2023, https://www.mcknights.com/news/cost-conversion-of-long-stay-residents-fuel-resistance-to-3-day-stay-waiver/. Accessed 27 April 2023.

Tara Lynott
Intern, Dougherty Leventhal & Price, LLP