The reasons Medicare won’t pay have frustrated the Rhode Island woman and many others trapped in the maze of regulations surrounding something called “observation care.”
Patients, like Gordon, receive observation care in the hospital when their doctors think they are too sick to go home but not sick enough to be admitted. They stay overnight or longer, usually in regular hospital rooms, getting some of the same services and treatment (often for the same problems) as an admitted patient — intravenous fluids, medications and other treatment, diagnostic tests and round-the-clock care they can get only in a hospital.
via Kaiser Health News.
Related Reading:
Make Hospital Observation Days Count in Medicare.
Today an increasing number of Medicare beneficiaries are hospitalized in observation (outpatient) status rather than being officially admitted as inpatients, which means Medicare will not pay for their SNF care. Rather, beneficiaries are required to pay for expensive nursing home care themselves, or they may be forced to forgo care if they cannot afford to pay.
S. 568 would alleviate this situation by counting a period of observation status in a hospital toward satisfying the three-day inpatient hospital requirement to be eligible for the Medicare SNF benefit.
