​ADVERTORIAL

There are approximately 13.2 million hospitalizations among adults aged 65 years and older in the United States each year, with one in four Medicare patients discharged to a skilled nursing facility (SNF) following acute hospitalizations.

Before the pandemic, Medicare beneficiaries were required to have a prior inpatient hospital stay of three consecutive days to be eligible for Medicare coverage of inpatient SNF care. Under the federal Public Health Emergency (PHE) for COVID-19, put into effect by the Department of Health and Human Services in January 2020, this three-day rule was waived, allowing temporary emergency coverage of SNF services to beneficiaries without a qualifying hospital stay, and extension of benefits for qualifying patients up to an additional 100 days.

On May 11, 2023, the PHE ended, with some provisions remaining in effect, while others were discontinued, including the waiver of the SNF three-day rule for Medicare beneficiaries. This change will impact SNFs yet again, as the nation works to return to pre-pandemic operations.

Curana Health understands both the impact of the PHE on the nation’s skilled nursing facilities and its ending varies. While the three-day stay waiver helped ensure patients had access to care during the pandemic, some operators still face resource challenges and declining financial health due to residual staffing and regulatory challenges, making the end of the PHE not welcome news for everyone.

Curana Health’s ability to provide an equivalent benefit to the PHE is unparalleled. It has developed benefits similar to the three-day rule, as well as the ability and experience to help partners navigate through the transition, regardless of position, and help return to operational efficiency.

Waiver of the three-day rule has always been a benefit of Align Senior Care, which is fully owned and operated by AllyAlign Health (AAH), Curana Health’s Medicare Advantage health plan. Additionally, as of January 1, 2023, Curana Health Medical Group’s participation in the High Needs ACO REACH program makes it possible for Curana Health’s clinicians to authorize “skill in place” episodes for qualifying residents in partner facilities. We estimate that the combination of our ACO and Medicare Advantage solutions can retain “skill in place” for as many as 80 percent of nursing home residents.

Whether the PHE end is welcome news, or poses challenges, Curana Health can help operators establish a more permanent path to financial and operational viability. Improving the health, dignity, and wellness of seniors is at the heart of our mission and a shared value in the communities and facilities we partner with.

Curana Health understands no two SNFs are alike. Each has unique needs relevant to their regions and populations. But we also believe all SNFs share the same goal—to help seniors live their most fulfilling life through great care. We welcome the role we can play to our partners and look forward to guiding operators through the ever-changing post-pandemic world.

Tony Gamboa, MD, MBA, CMD, is chief growth and innovation officer at Curana Health. With a presence in 26 states and partnerships with well over 1,000 senior living communities, including skilled nursing facilities, assisted living facilities, and life plan communities, Curana Health is on a mission to improve the health, happiness, and dignity of senior living residents—innovating solutions for senior care delivery with a unique focus on prevention and care coordination. To learn more, visit curanahealth.com.