156 Centers for Medicare and Medicaid Skilled Nursing Facility 3-Day Waiver Pilot: Evaluation of Emergency Department Length of Stay for Direct Admission to Skilled Nursing Facilities

Abstract

The Skilled Nursing Facility (SNF) 3-Day Rule requires that Medicare beneficiaries have an inpatient hospital stay of three consecutive days within the past 30 days to be eligible for coverage of SNF admission. However, there is opportunity within the Centers for Medicare & Medicaid Services (CMS) Shared Savings Program for waiver of this rule for eligible beneficiaries who are prospectively assigned to an Accountable Care Organization (ACO) and who receive care from an eligible SNF. The objective of this pilot study was to evaluate the emergency department (ED) length of stay (LOS) of participating Cleveland Clinic Ohio ED ACO patients who were discharged directly to an eligible SNF under the waiver.