HB996, HB1021, Nursing Facilities, Long-Term Care, Home & Community-Based Services

Joint Committee on Health Care Financing

The Massachusetts Hospital Association (MHA), on behalf of its member hospitals and health systems, appreciates this opportunity to offer comments on the bills highlighted below.

MHA strongly supports HB996. This legislation would direct MassHealth to pay to reserve nursing facility beds for MassHealth recipients for a period up to ten days if the nursing home resident enters a hospital. It also directs MassHealth to pay to reserve the beds of nursing facility residents for a period up to fifteen days when a resident leaves the nursing home for non-medical reasons. Bed-hold payments guarantee elders the option of returning to the same room and facility where they currently reside and receive services from a care-giving team that is familiar to the patient. The importance of such familiarity between caregiver and patient, and its effect upon cost-efficient, quality care, and comfort, particularly to our senior population, should not be underestimated.

Without the passage of HB996, nursing facilities will be limited in their ability to work with patients and their families to secure a return to the same facility. If there is a new patient/resident that requires a bed in the timeframe that the current resident is receiving care in the hospital, the current resident who had a medical leave of absence would lose the ability to return to the bed in that facility. From a continuity of care perspective, providing a known and comfortable environment for elderly residents when they return from an acute or urgent treatment is crucial to their recovery. In addition, for those elders who may need routine tests or basic ancillary services that may result in an observation or one-day stay in the hospital, eliminating the worry that they might lose their bed will help reduce that individual’s anxieties and potential medical complications. Hospital case management staff experience significant challenges finding available nursing facility beds in their local area at the time that most elders are ready to be discharged from the hospital. Forcing a nursing home resident who needs services at an acute care hospital to risk losing their bed and potentially wait in the hospital until another bed in a different facility/location is found poses significant chronic and behavioral health consequences for elders. The ability to return to the same nursing facility, and same bed, is even more crucial for these patients. HB996 will help ensure the best standard of care for nursing facility residents and will facilitate the appropriate placement of hospital patients. MHA respectfully urges the committee to issues this bill a favorable report.

While MHA supports the principles addressed by in HB1021, we oppose the bill, as drafted. This legislation requires the Department of Public Health (DPH) to put forward regulations on the minimum technical criteria for medical diagnostic equipment. While hospitals agree with the necessity of having accessible medical equipment, especially for patients who have disabilities, we are concerned that the potential state regulations promulgated under this legislation may be duplicative to or go beyond those established by the federal government. Through the federal Affordable Care Act, the national Architectural and Transportation Barriers Compliance Board created an Advisory Committee to make recommendations to the Board on how to ensure that medical diagnostic equipment used in physicians’ offices, clinics, emergency rooms and hospitals is accessible to, and usable by, individuals with accessibility needs. This includes equipment such as exam tables, chairs, X-ray machines and other radiological equipment. While the Board has received the advisory committee’s report and put forward proposed standards, the Board has yet to finalize the standards after receiving extensive comments and the advisory committee’s recommendations. MHA urges the Committee to take no action on this legislation in lieu of the fact that new federal standards will soon be established. The potential for duplicative and/or conflicting standards poses significant implementation barriers and would force the imposition of unnecessary administrative barriers and costs without offering any benefit to patient care or access.

Thank you for your time and your consideration of these matters. If you any questions or need further information, please do not hesitate to contact Michael Sroczynski, MHA’s Vice President of Government Advocacy at (781) 262-6055 or msroczynski@mhalink.org.