🔒CT bill seeks to license long-term, acute care hospitals

A bill in the state legislature seeks to create a licensing process for long-term acute care hospitals in Connecticut. Senate Bill 193 was introduced by the Public Health Committee and was the subject of a public hearing held Wednesday. Just two people submitted testimony — Commissioner Manisha Juthani of the state Department of Public Health, who testified against the bill, and Tara Knapp, vice president of external affairs for Gaylord Specialty Hospital in Wallingford, who expressed support for the bill. Gaylord is one of just three such facilities in Connecticut, along with the Hospital for Special Care in New Britain and the state Department of Veterans Affairs’ Sgt. John L. Levitow Veterans Health Center in Rocky Hill. Juthani testified that her department currently licenses four chronic disease hospitals, which are defined in state statutes as “long-term hospitals with facilities, medical staff, and all necessary personnel” to diagnose, care and treat chronic disease. The bill would create a new category of “long-term acute care hospital,” as defined by referencing federal law. The federal law defines such facilities as a long-term hospital that provides”inpatient services to Medicare beneficiaries and has an average stay of greater than 25 days.” Juthani said DPH believes the current CDH license “meets the needs of patients served by these facilities,” and added that it is “unclear” how creating a new category would “benefit patients, improve health care quality, safety and care delivery.” She added that the bill as currently drafted could result in “a number of unintended consequences.” First, she said the bill fails to add the new license category to the definition of long-term care facility in a separate state statute that requires background checks of potential employees for criminal history and patient abuse. Second, by using the federal definition, “these facilities would be required to primarily accept Medicare, which could limit the number of Medicaid and private insurance patients that the facility could accommodate,” she said. “There is no other facility licensed by DPH with such a requirement.” She concluded by stating that due to the cost of developing and monitoring the new license category, which is not included in the governor’s proposed budget, “DPH cannot support this bill.” Knapp told the committee that Gaylord, as a long-term acute care facility, is not the same as a chronic disease hospital. “We care for medically complex patients who still require hospital-level treatment, often for weeks,” she said. Misclassifying long-term acute care facilities as a chronic disease hospital affects insurance coverage and patient reimbursement, because patients can be required to use rehab benefits instead of hospital benefits by insurers, which can limit recovery options, she said. “Medicare Advantage plans frequently deny authorization because our state classification doesn’t align with the federal designation,” Knapp said. She said Gaylord proposes the state create a licensing subcategory for long-term acute care hospitals within the current licensing framework, which would align with the federal designation and provide clarity. Sen. Saud Anwar (D-South Windsor), a doctor and co-chair of the Public Health Committee, said he was concerned that DPH is not supporting the bill and wondered why other states have been able to address this issue. “I think other states have not had as much difficulty of doing this,” he said. “So I am going to be interested to see why other states can do this and why the state of Connecticut is having so many challenges.” Anwar, Juthani and Knapp all said they were willing to participate in additional conversations about the bill.