Hospital overcrowding is leading to increased patient “boarding” in emergency rooms (ERs) across America. Patients, who are ready to be discharged, are stuck in the hospital because there are not enough beds in skilled nursing facilities (SNFs) or home health providers in their area, thereby creating back-ups among patients in the ER waiting for admission. We need to expand post-acute care options urgently.


Skilled nursing facilities primarily provide inpatient skilled nursing care and related services to patients who require medical, nursing, or rehabilitative services, but does not provide the level of care or treatment available in a hospital. Medicare pays SNFs a predetermined amount per day that a beneficiary receives care, up to 100 days.

According to data from 2019 and 2020, total Medicare SNF spending increased $1.1 billion (4.4 percent), despite 200,000 fewer traditional Medicare beneficiaries using SNF services in 2020. Average spending per SNF user was $2,724 (16.3 percent) higher in 2020 compared to 2019, driven by an increase in average spending per day (+$44), with an increase in the average length of stay (+1.6 days) also contributing.

During the COVID-19 pandemic, CMS waived the requirement that Medicare beneficiaries have a three-day hospital stay before being admitted to a SNF. Medicare beneficiaries with COVID-19 were 66 percent more likely to be discharged from the hospital to a SNF than non-COVID patients, increasing occupancy levels above what they would have been otherwise.

SNF-at-home provides opportunities for payers, health systems, and providers to lower costs, facility-associated infections, promote patient compliance, free up capacity in facilities, and address practitioner burnout. SNF-at-Home may not be a fit for every patient, but it is an important option for patients and providers to have. An integrated SNF-at-home program can bring services directly to the patient, allowing them to recover in a familiar environment.

Moving Health Home’s Post-Acute Recovery at Home Act would allow Medicare beneficiaries who qualify for a SNF stay to receive post-hospitalization services at home. Read more about the bill here or below:

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Americans want home to be the center of their health:

  • Americans Are Comfortable Receiving Care in the Home
    • 70 percent of those surveyed are comfortable with care in the home citing that familiarity helps alleviate anxiety and improve communication. This is especially important for those from underserved and minority communities.
  • Americans Are Confident in the Quality of Receiving Care in the Home
    • 73 percent of adults are confident in the quality of receiving care in the home.
    • 85 percent of caregivers are confident in the quality of receiving care in the home.
    • 88 percent of adults were satisfied with the clinical care services they received in the home.
  • Americans Prefer and Would Recommend Care in the Home
    • 85 percent of people who have had experience with care in the home would recommend it to family and friends.
  • Americans Support Expanded Care in the Home
    • A bipartisan majority of consumers say it should be a priority for the federal government to increase access to clinical care in the home (73 percent Democrats, 61 percent Republicans).

Moving Health Home believes care in the home refers to a spectrum of health services provided in the home or place of dwelling outside of a facility, such as skilled nursing services, among others.

The Choose Home Care Act of 2021, led by National Association for Home Care & Hospice (NAHC) and the Partnership for Quality Home Healthcare, aimed to improve extended care services and supports for Medicare beneficiaries with skilled care needs and functional limitations who choose to receive care in their homes. Read more here.

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