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AHCA/NCAL Statement on OIG Report on Observation Stays Policy  
AHCA/NCAL Statement on OIG Report on Observation Stays Policy
Report urges CMS to ensure access to skilled nursing care for beneficiaries
Contact:                (202) 898-3165

Washington, DC –American Health Care Association and the National Center for Assisted Living (AHCA/NCAL) President and CEO Mark Parkinson today issued the following statement following the release of a Department of Health and Human Services’ (HHS) Office of the Inspector General (OIG) report:
“The OIG report is just one more argument in favor of changing these arcane laws and speeding care to thousands of seniors trapped in this no man’s land of health care. We hope this federal affirmation by the Inspector General will echo around Capitol Hill as lawmakers consider our proposed legislation. The time for Congress to pass this bill is now.”
The memorandum report focused on the Centers for Medicare and Medicaid Services’ (CMS) proposed rule regarding hospitals’ use of observation stays and short inpatient stays for Medicare beneficiaries. The report found that hospitals varied in patient admission placement, despite similar patient symptoms. The lack of clarity in the distinction between an inpatient and observation stay complicates issues for patients, who may be denied skilled nursing benefits under Medicare Part A if they do not meet the three-day inpatient stay minimum requirement. The report urges CMS to count observation days towards this three-day minimum.
AHCA/NCAL continues to support legislation that would solve this observation stay loophole. The Improving Access to Medicare Coverage Act of 2013 (S. 569/H.R. 1179) would deem time an individual spends under observation status eligible to count towards satisfying the three-day requirement.
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The American Health Care Association and National Center for Assisted Living (AHCA/NCAL) represent more than 13,000 non-profit and proprietary skilled nursing centers, assisted living communities, sub-acute centers and homes for individuals with intellectual and developmental disabilities. By delivering solutions for quality care, AHCA/NCAL aims to improve the lives of the millions of frail, elderly and individuals with disabilities who receive long term or post-acute care in our member facilities each day. For more information, please visit or