Aging Parents: “In Patient” vs “Under Observation” — How Being in a Hospital Bed can Fool You

Does being in a hospital bed qualify Medicare-eligible seniors as In-Patient?

For some time now, we’ve been hearing about Medicare-eligible seniors who’ve been given “Under Observation” status when admitted to hospitals–for what any intelligent person would assume should be “In-Patient” status. “Under Observation” status is not “In-Patient.” 

If parents need to enter a skilled nursing facility or a nursing home after the required three days of hospitalization, Medicare will not pay and the family will be required to pay all of the bills, including the hospital costs, if hospital status was “Under Observation.”

We might also assume that those in a bed in a hospital are automatically considered “In-Patients.” Not true. Hospitalization for those designated “Under Observation”–even if they’ve been lying in a hospital bed for the three days before going to a skilled nursing facility or nursing home–does not qualify them for Medicare reimbursement. 

If this is news to you, you’ll want to click on this February 6, 2014 FoxNews. com article with video. It explains the factors contributing to the admissions status problem, as well as the many difficulties with the appeals process experienced by “Under-Observation”-Medicare-enrolled patients, who were denied reimbursement.

There is a key word in the first two paragraphs: assume.  Sr. Advisor R, as readers know, is amazingly wise about handling life and will be 101 in September. Her wise words were the subject of an earlier post.  “Don’t Assume” is an example of R’s wise words. Perhaps that’s one reason she has navigated the challenges of life so well.

May the FoxNews link help all Medicare-eligible seniors and their caregiver children to better navigate the hospital-admissions-status challenge and all that follows.

Personal note: My Tuesday, Saturday posting schedule is still ify, so my goal of one post a week remains for the time being. My out-patient procedure in the hospital this past week (no bed involved) prompted this post when I learned that some of my “learned friends,” who are on Medicare, were clueless about the important bed nuance.

Changing often: “Of Current Interest” (right sidebar near bottom). Links to timely information and research from top universities, plus some fun stuff–to help parents age well. (Note 5/17/14 addition from Harvard Medical School for Caregivers)