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New CMS Medicare Rule Undercuts Ability of SNFs to Care for Higher Acuity Patients, as Intended by Law

AHCA, Alliance Warn $5 Billion, Five-Year Regulatory Funding Cut Ignores Changing SNF Patient Profile

WASHINGTON, May 1 /PRNewswire-USNewswire/ -- The nation's two leading long term care organizations warned that a key component of a newly-issued rule from the Centers for Medicare and Medicaid Services (CMS), and other changes announced today, will slash Medicare-financed nursing home care by approximately $5 billion over five years. This regulatory cut, leaders of the American Health Care Association (AHCA) and the Alliance for Quality Nursing Home Care say, gives with one hand, and takes away with another, and will significantly hinder skilled nursing facilities' (SNFs') ability to care for the higher-acuity patient population actually intended by CMS policy.

"Our profession is alarmed by the CMS action taken today, which we initially estimate will have the net effect of cutting SNF payments by approximately $5 billion over five years," said Bruce Yarwood, President and CEO of AHCA. "The policy we are currently following, as intended by existing law, improves our ability to care for a higher acuity patient population. The CMS changes, which we will now analyze in detail and comment upon as warranted, gives with one hand and takes away with another -- leaving frail, elderly seniors in greater jeopardy as a result."

Alan Rosenbloom, President of the Alliance, stated, "Regulatory-driven budget cuts like those incorporated into the CMS rule would inhibit skilled nursing facilities' ability to continue caring for increased numbers of high-acuity patients, and undermine our ongoing efforts to invest in and build the necessary clinical infrastructure to ensure care quality is maximized. As this detailed 139-page rule requires close scrutiny and study, our initial reaction is that it will unquestionably place at risk our long-standing goals of increased efficiency and effectiveness -- which benefits nursing home patients, our caregiver workforce, and taxpayers alike. Substantial modification is in order, and we urge Congress to carefully scrutinize this CMS directive."

Independent studies indeed confirm SNFs provide post-acute rehabilitation to dramatically more patients than in the past -- and at a significant savings to the Medicare program. A recent United Hospital Fund report, for example, found that the number of patients in New York State staying in a nursing home for less than two months more than tripled from 1996 to 2005. In addition to this rise in short-stay patients, the study further concluded that, "between 1996 and 2005, both long-term residents and short-term patients have become more disabled, and more of them are cognitively impaired."

Yarwood and Rosenbloom said the UHF report exemplifies the increased role that SNFs play in this arena -- not just in New York State, but nationwide. "This growing positive trend has been driven, in large measure, by intelligent and sound Medicare policy changes designed to move patients to the lowest cost, most appropriate setting," observed Rosenbloom.

"As the nature of the nursing home patient population continues to change and evolve, it is incumbent upon the federal government to help facilitate the ability of SNFs to accommodate the care needs of high-acuity, post-acute Medicare beneficiaries," Yarwood continued. "Unfortunately, a key piece of the CMS rule published today is directly contrary to this highly desirable health care policy objective."

SOURCE American Health Care Association
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