Statements on Introduced Bills and Joint Resolutions

Floor Speech

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By Mr. ROBERTS (for himself, Mr. NELSON of Florida, Mr. CRAPO, Mr. WYDEN, Mr. TOOMEY, and Mr. HELLER):

S. 1486. A bill to amend title XVIII of the Social Security Act to clarify and expand on criteria applicable to patient admission to and care furnished in long-term care hospitals participating in the Medicare program, and for other purposes; to the Committee on Finance.

Mr. ROBERTS. Mr. President, I rise today to introduce the Long-Term Care Hospital Improvement Act of 2011, with the support of my colleague Mr. NELSON of Florida. This legislation develops new federal standards and certification criteria for Long Term Acute Care Hospitals, LTCHs.

We are also joined by Senators CRAPO, WYDEN, TOOMEY and HELLER, in introducing this bill. We hope to get the support of many more of our colleagues.

This legislation has the support of the major hospital associations, including the American Hospital Association, AHA, the Federation of American Hospitals, FAH, and the Acute Long Term Hospital Association, ALTHA.

As many of you know, Long-Term Acute Care Hospitals, referred to as LTCHs, specialize in treating medically complex patients who need longer than usual hospital stays, on average 25 days. By comparison, the average stay for a patient in a general acute hospital is only 5-6 days.

LTCHs, like rehabilitation hospitals and nursing homes, often care for patients who are discharged from a general hospital. Because of that, LTCHs are sometimes referred to as post-acute care providers. However, LTCHs are fully licensed and certified as acute care hospitals. There are approximately 425 LTCHs in the nation, compared to approximately 12,000 nursing homes and 1,400 rehabilitation hospitals. LTCH patients are very ill, with many suffering from complex respiratory issues, including those who are ventilator dependent, or other complex medical issues. LTCHs account for about of Medicare spending.

The bill that I am introducing today implements a comprehensive set of federal criteria that will supplement existing Medicare classification criteria for LTCHs. These criteria are designed to ensure that LTCHs are treating high acuity patients who need extended hospital stays. Analysis by the Moran Company estimates that these criteria could generate approximately $374 million over 5 years and $2.7 billion over 10 years. The bill is expected to result in a net savings of $500 million over 10 years. I plan to work with CBO to confirm that estimate.

This legislation will generate savings for the Medicare program; promote patients being cared for in the most appropriate setting; and, protect access to LTCH care for medically acute beneficiaries who need extended stays due to their complex condition.

This is not a new concept and the American Hospital Association has been working on this issue for years. In August 2010, the AHA initiated a workgroup representing a cross section of the nation' LTCHs and larger general hospital systems including Geisinger Medical System, Pennsylvania, and Partners HealthCare System, Inc., Boston. The goals of the AHA workgroup were to develop policy recommendations for uniform LTCH patient and facility criteria; distinguish LTCH hospitals from general acute hospitals and all post-acute settings; assess fiscal impact, with goal of showing overall Medicare savings; develop consensus among AHA's LTCH members; and achieve relief from the LTCH ``25 percent Rule.''

We believe that we have accomplished these goals with my legislation. Additionally, for a body that just voted on a debt ceiling increase, this bill has the potential to achieve significant savings.

I hope that my colleagues will agree with me and that this legislation is something that they can support. I urge my colleagues to join me in cosponsoring the Long-Term Care Hospital Improvement Act of 2011.

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