SJR 8, as introduced, Hernandez. Medicare: observation status.
This measure would urge Congress and the President of the United States to reform the short stay admissions criteria for Medicare beneficiaries and to discontinue the two-midnight policy.
Fiscal committee: no.
P1 1WHEREAS, The federal Centers for Medicare and Medicaid
2Services set rules for hospital stays for Medicare beneficiaries;
3and
4WHEREAS, These rules govern admissions for the elderly, our
5most vulnerable patient population; and
6WHEREAS, Federal guidelines drive physician habits and
7hospital policy as Medicare is the largest purveyor of health care
8in the state; and
9WHEREAS, The federal Centers for Medicare and Medicaid
10Services’ guidelines state that patients are not to be formally
11admitted as a hospital inpatient unless the physician expects the
12patient’s condition to warrant a stay of at least two nights; and
13WHEREAS, This “two midnight” determination creates arbitrary
14decisions for hospital admissions that are not based on the clinical
15condition of the patient but rather an expected length of stay; and
16WHEREAS, Hospital admission decisions should be made by
17a licensed physician, assessing the appropriate care for the patient
18and not an arbitrary time-driven guideline; and
P2 1WHEREAS, The two-midnight policy has caused many seniors
2to be kept in “observation status” without formal admission as a
3hospital inpatient; and
4WHEREAS, These patients believe they have been admitted as
5a hospital inpatient when in fact they have not, leading to confusion
6for both the patient and their family; and
7WHEREAS, Medicare will not pay for skilled nursing facility
8care unless a senior has been admitted as a hospital inpatient for
9at least three days; and
10WHEREAS, The observation policy, which resulted from the
11federal Centers for Medicare and Medicaid Services’ guidelines,
12has denied seniors the appropriate criteria for admission to skilled
13nursing facilities because time spent in “observation status” does
14not count as a qualifying hospital admission; and
15WHEREAS, The observation stay practice is not in the best
16interests of patients, hospitals, and health care professionals; now,
17therefore, be it
18Resolved by the Senate and the Assembly of the State of
19California, jointly, That the Legislature respectfully urges Congress
20and the President of the United States to reform the short stay
21admissions criteria to more accurately reflect the clinical needs of
22a patient as determined by a physician and to discontinue the
23two-midnight policy that is currently in place; and be it further
24Resolved, That the Secretary of the Senate transmit copies of
25this resolution to the President and Vice President of the United
26States, to the Speaker of the House of Representatives, to the
27Majority Leader of the Senate, and to each Senator and
28Representative from California in the Congress of the United
29States.
O
99