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Observation Stays the Focus of Hearing  
Observation Stays the Focus of Hearing
AHCA/NCAL Commends Senate Special Committee on Aging
For Immediate Release                                
July 30, 2014

(202) 898-3165


Washington, D.C. – The American Health Care Association and National Center for Assisted Living (AHCA/NCAL) commends Senate Special Committee on Aging Chairman Bill Nelson (D-FL) and Ranking Member Susan Collins (R-ME) for convening a hearing focused on the observation stays issue.  The hearing, titled Admitted or Not? The Impact of Medicare Observation Status on Seniors, will take place today at 2:15 p.m. ET. 

“Today’s hearing is another step forward in addressing this critical issue,” said Mark Parkinson, President and CEO of AHCA/NCAL. “I’m hopeful that this positive momentum will continue and that those who need our services the most will see a fix to this problem soon.”

Hospital stays classified as observation, no matter how long and no matter the type or number of services provided, are considered outpatient.  These hospital stays do not qualify patients for Medicare-covered care in a skilled nursing center.

Participating in the hearing will be ACHA/NCAL member Bob Armstrong, Vice President of Elder Care Services for St. Mary's Health System in Lewiston, Maine.  As a long term care administrator for over 29 years, Mr. Armstrong will speak about the impact the observation stays issue has had on residents and their families.  He will also ask that Congress pass and sign into law bipartisan legislation that Representatives Joe Courtney (D-CT-2) and Tom Latham (R-IA-3), along with Senator Sherrod Brown (D-OH) introduced.  The Improving Access to Medicare Coverage Act of 2013 (S. 569/H.R. 1179) seeks to count all hospital days spent in observation towards the three-day inpatient stay required for Medicare coverage of Part A skilled nursing care benefits. 

Mr. Armstrong will also speak about other legislation that he and AHCA/NCAL support. Representative Jim Renacci’s (R-OH-16) bipartisan Creating Access to Rehabilitation for Every Senior (CARES) Act of 2013 (H.R. 3531) eliminates the three-day inpatient stay requirement by allowing centers that meet particular criteria to automatically qualify to waive the prior hospitalization requirement.  A similar bill introduced by Representative Jim McDermott (D-WA-7) the Fairness for Beneficiaries Act of 2013 (H.R. 3144), seeks to also eliminate the three-day stay requirement.

A full version of Mr. Armstrong’s testimony is available here.

Members of the public can watch the hearing live at:

For more information about observation stays and the three-day stay requirement, visit the AHCA/NCAL website.


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