QUINCY, IL – Quincy Medical Group is now a participant in UnityPoint Accountable Care, L.C.’s. Next Generation Accountable Care Organization (ACO), an initiative overseen by the Centers for Medicare & Medicaid Services (CMS) Innovation Center. As part of its participation, Quincy Medical Group can now offer a waiver of the three-day stay requirement for skilled nursing facility (SNF) referrals for Medicare beneficiaries who are part of the Next Generation ACO initiative.
The SNF 3-day waiver is a benefit enhancement which waives the 3-day minimum necessary inpatient stay before admission into a skilled nursing facility. Under original Medicare guidelines, patients must have a hospital inpatient stay of at least three nights before being transferred to a SNF for care. This requirement is waived for eligible Next Generation ACO beneficiaries as a result of Quincy Medical Group’s participation in the Next Generation ACO. It is intended to provide flexibility for patients who would benefit from the SNF level of care and who do not need inpatient treatment and do not qualify for home health services.
“We strive to provide patients with appropriate care for their situation,” said Tena Jones, Director, Quality & Process Improvement with Quincy Medical Group. “This option provides a more direct path for patients to get the care they need.”
Three of our skilled nursing partners are approved for this benefit enhancement for 2017: The Good Samaritan Home of Quincy, Barry Community Care and Lewis County Nursing Home. An approved SNF is one that is participating with UnityPoint Accountable Care, L.C. and has an overall rating of three or more stars under the CMS 5-Star Nursing Home Quality Rating System. Beneficiaries are always permitted to go to the SNF of their choice, but may not be eligible for reimbursement without a 3-day inpatient stay if they choose a SNF other than one approved for this benefit enhancement that is participating with UnityPoint Accountable Care, L.C.
“The benefits to the community are extensive,” stated Mark Huebotter, Administrator of Lewis County Nursing Home. “The waiver allows individuals to avoid hospitalization if their condition doesn’t require it. If patients meet the criteria, they can be admitted directly to our facility and begin getting the services they need.”
Eligible Next Generation ACO beneficiaries can utilize the waiver and be admitted to a SNF from their home, provider’s office, or hospital.
Quincy Medical Group has qualified Care Managers to assist with identification, eligibility, admission and management. For more information visit quincymedgroup.com