CMS Introduces 3-Day Waiver

Unless you work in health care or have a loved one currently in a rehab community, you probably aren’t familiar with something called the COVID 3-Day Waiver. It has a much fancier name according to the Centers for Medicare and Medicaid, but for simplicity’s sake, it is the 3-Day Waiver. This waiver was put in place as hospitals began to reach capacity during peak COVID times. It is intended to prevent the hospitals from being overwhelmed and limit the chances of COVID exposures for high-risk patients.

Traditional Citeria

Typically, if a person is in the hospital due to a broken hip, knee replacement, stroke, or other ailment along those lines, they would start to hear people mention something about a 3-night stay. Traditionally to qualify for a stay in short-term rehab, guidelines have said that you have to have a skilled need (a medical condition that is deemed medically necessary for you to be cared for in a certain setting) in addition to a 3 midnight stay in the hospital. Once those criteria were met, Medicare would then say you are eligible to use your SNF Benefit (short-term facility benefit of up to 100 days inpatient rehab).

Once the waiver took effect, these rules changed. The Waiver states if you have a skilled need, and Medicare to pay for it, then the healthcare industry now has the ability to make it easier, and faster for you to get to where you need to be, with fewer hurdles to jump over. Now those hurdles are more imaginary to the patient and handled on the back end by healthcare workers such as myself!

Waiver Simplified

The waiver, in short, allows patients that meet certain criteria to bypass the 3 midnights and enter a rehab community straight from the ER, Observation status, Outpatient Surgery, and even straight from home! This can mean patients getting the rehab that they need faster. Not only do they have the option to enter rehab sooner, and get the recovery process started faster, it also offers the potential to save the patient money. There is no question that a hospital stay isn’t cheap, so if healthcare providers can shorten the hospital stay and still provide the care needed, then this sounds like a win! Keep in mind that while all of this is benefiting the patient, it is also a huge help to hospitals that are still very overwhelmed with high acuity patients and low staffing numbers.

I mentioned previously that an option covered in this waiver is the opportunity to skip a hospital stay all together. Let’s use the example that a patient has a fall, is seen in the ER, and is discharged home, thinking that they can handle their own care at home. In the past, if the patient were to realize that they were not able to safely remain at home, they would then have to return to the hospital. The Waiver instead allows the patient to admit straight to a short-term rehab from home.

How Long is it in Effect?

This waiver can only be renewed 90 days at a time. We just passed a renewal date, so we now have until mid-October to take advantage of this waiver option. My biggest hope is that this temporary waiver will give a glimpse into how much easier we could make things for our patients and healthcare workers in the future by adopting this waiver as common practice. (While I have tried to simplify a very complex waiver process as much as possible, please understand that there are many details, criteria, and stipulations that go along with this waiver being used.)

Interested in Learning More?

If you would like to learn more about the 3-Day Waiver or have further questions, feel free to contact me at 812-243-2609 or via email at alark@phcwoods.org.