November 29, 2007 Issue
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Classified Chestnut Hill Local Don't Miss an Issue, Tell us what you see or Winner of Two |
Rehab hospital seeks change in Medicare patient limits
Those who undergo a serious illness or emergency, such as a stroke, amputation or brain injury, use rehabilitation services to help them and their families adapt and adjust to a new way of living. According to a local rehab hospital, the Montgomery Rehab Hospital of Chestnut Hill, an important inpatient service that provides patients with this well-rounded treatment — from physical rehab to psychological counseling — is being threatened by restrictions on the Medicare patients it treats. The hospital administration invited U.S. Congresswoman Allyson Schwartz to its facilities to advocate for a change in those restrictions, which would allow inpatient rehab access to more patients, said the hospital. Montgomery Rehab — formerly Chestnut Hill Rehabilitation Hospital before it was taken over by the Florida-based health care management company Traditions Management in May — is a for-profit rehabilitation inpatient facility that provides both inpatient and outpatient rehabilitation. The hospital’s facilities are situated on a larger campus providing medical and elderly services at 8601 Stenton Ave. and has the capacity to house 39 inpatient acute rehabilitation patients — or those that receive comprehensive physical and psychological treatment from five days to five months, said Dr. Matthew Schwartz (no relation to the Congresswoman), the hospital’s medical director. But the hospital is rarely able to use its full 39 beds and is concerned for its future. The Centers for Medicare and Medicaid Services, a part of the U.S. Department of Health and Human Services that oversees the federal government’s disbursement of federal healthcare funds, has 13 “compliant” type cases that qualify for the acute inpatient rehabilitation services to be covered by federal health insurance. These are certain amputations, burns, brain injuries, congenital deformities, hip fractures, multiple major traumas, neurological conditions, spinal cord injuries, stroke, joint replacement, rheumatoid arthritis, system vasculidities and multiple joint osteoarthritis. Rehabilitation hospitals can treat any number of these patients, as long as they have the capacity, and can be reimbursed with federal dollars. Based on the number of these compliant patients a hospital is serving at a given time, a hospital can also admit noncompliant Medicare cases — patients that suffer from bad arthritis or major heart or lung surgery, for example. Currently the CMS requires that at least 75 percent of its patients must have a problem that falls within that 13-type category for the hospital to meet the criteria as an “inpatient rehabilitation facility.” This causes the hospital to have to turn away patients that could benefit from the rehab hospital’s care, said Diane Huntoon, the hospital’s chief executive officer. “We turn away dozens and dozens of patients,” Huntoon said. Specifically, in the past three months they have turned away 64 patients, said Maureen Robertson, the hospital’s marketing director. By inviting Congresswoman Schwartz to their facilities, Montgomery Rehab was hoping to convince her to stand strongly behind legislation that would put the ratio of compliant to noncompliant patients at 60-40. Schwartz’s legislative aid on health care, Kate Gross, said a Medicare bill is usually introduced annually at the end of each Congressional session, which ends at the close of the year, and Schwartz is considering including the 60-40 ratio for rehab hospitals in that annual legislation. But, during her visit, Congresswoman Schwartz did not sugarcoat the likelihood of the legislation passing and warned the hospital that it was an expensive change and that other less expensive changes were needed. She said the 60-40 change might be sacrificed for other changes in Medicare. She did say, however, that it was likely to be included in the initial soon-to-be-introduced Medicare legislation, which her aid echoed. “It’s being considered as part of the Medicare package,” Gross said. Contact staff writer Kristin Pazulski at 215-248-8819 or Kristin@chestnuthilllocal.com.
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