During the Covid-19 pandemic, governments used a series of waivers and regulations to make temporary changes to healthcare policies. This flexibility was allowed due to California’s State of Emergency (which ended on February 28th) and the federal Public Health Emergency (set to expire on May 11th). Healthcare policies through MediCal/Medicaid and Medicare are now expected to revert to their pre-pandemic status.
Two significant changes impacting skilled nursing facilities are:
- Medicare will return to the 100-day yearly maximum stay. During the pandemic, Medicare allowed for extensions to the number of days a person is allowed to stay in a skilled nursing facility per year. Now that the state of emergency ended, the policy will again be enforced.
- The 3-day inpatient rule requires that an elder spend at least 3 consecutive days being treated on “inpatient” status in a hospital to qualify for skilled nursing facility admission or readmission. However, many hospitals admit people on “observation” status and do not admit them to the hospital as inpatients. It is very important to always work with the hospital Social Services department to be sure your loved one is being treated appropriately as an inpatient or Medicare will not pay for a follow up stay at a skilled nursing facility.
The pandemic policies were meant to be temporary, although they lasted several years. This situation can lead to some confusion as we “return to normal.” As always, we are committed to serving our community and will keep you informed to the best of our ability.