A proposed change in Medicare coverage could help more seniors in Chautauqua County.
Sen. Charles Schumer, D-NY, said he is proposing legislation that would change Medicare rules involving hospital stays and the rehabilitation that follows. Current standards require seniors to pay out of pocket for follow-up treatment if they were considered to have "observation status" while at a hospital.
As a result, seniors are paying thousands of dollars for assistance at nursing homes and other treatment facilities, Schumer told reporters in a conference call Wednesday.
Sen. Chuck Schumer
"In recent years, there's been a huge uptick in elderly patients under observation status at Upstate New York hospitals, and it's leaving seniors high and dry and hospitals no better off," Schumer said.
"A flawed part of Medicare law is to blame, and I have a plan to change that, so New York's over 3 million Medicare beneficiaries are not at risk of being hit with huge rehabilitation bills after a lengthy hospital visit."
Schumer's bill, dubbed the "Improving Access to Medicare Coverage Act," would allow seniors to receive Medicare-covered rehabilitation regardless of their hospital stay. Recipients currently are required to be inpatient for three days at a hospital in order to qualify for Medicare-subsidized assistance.
There are more than 151,500 Medicare beneficiaries in the Southern Tier region. In Western New York, that number is 270,000.
Colleen Wright, Chautauqua County Home finance director, said Schumer's pitch makes sense for seniors in the county, many of whom rely on federal assistance for medical coverage.
"It would be wonderful," Wright said. "I think the senator said it best. It would help seniors who couldn't afford the rehab when they aren't covered by Medicare."
Wright said families of seniors also would benefit.
"It's going to help the families, too," she said. "A lot of the times family members are confused with the practice. (Seniors) come out of the hospital and you assumed they were inpatient, which is covered by Medicare.
"It's really going to be a great thing if it's passed."
David Smeltzer, Heritage Ministries executive director, also is encouraged by Schumer's plan.
At any given time, Heritage Ministries has 50-60 rehabilitation patients in its facilities.
"It's what's right," Smeltzer said of a law change. "If they have the benefits they should have access to the care, regardless of what a hospital has to say. It's not about us. It's about making sure those who are entitled to the care receive all of the benefits."
The average cost of residing at a nursing home, Schumer said, is $356 a day. That does not include cost of rehabilitation or therapy services.
As an example, the senator pointed to an Albany man who recently broke his pelvis. The hospital, which did not perform a surgery or procedure, classified him as an observation patient. As a result, the man paid out of pocket for his three weeks in rehabilitation.
Asked if nursing homes are supporting his legislation, Schumer said, "Absolutely. They understand that these seniors are not getting the coverage they need to pay their bills."
Wright said the County Home had 200 admissions last year for rehabilitation. Five of those admissions were not covered by traditional Medicare due to their observation status while at a hospital. Wright noted one of those not covered did receive assistance through Medicaid.
Wright said some therapy services can be covered by Medicare Part B. She added that room rates are slightly lower than the state average; a private room costs $287 a day.
"I totally support Sen. Schumer's efforts to get this changed," Wright said.