Coming face to face with your own mortality is not necessarily a bad thing. It makes you think about the bigger picture and your own legacy. Read more…
Keeping Seniors At Home
I have created a survey of technology, low and high, readily available that affords greater independence to seniors in their daily lives. You can see it at Keeping Seniors at Home with Help of Technology. These technologies provide safety to them as well as comfort to those that care for them. They are, by and large, affordable and will emerge as a democratizing force in the society. At this moment, aide is available for the poorest (vis-à-vis the entitlement structure) and the wealthiest. However, a great mass of American elders fall into a gap wherein they emerge receiving sub-par care, live lives with greater risk than necessary or are forced out of their homes to institutions that otherwise would not be indicated.
-Mark Zilberman, LCSW
WHAT IS HOSPITAL “OUTPATIENT” OBSERVATION STATUS?
A hospital billing classification that can make Medicare patients pay for the cost of their:
Nursing Home Care
Patients must be classified as inpatients for 3 days in the hospital in order for Medicare to pay for subsequent nursing home care.
May be called “outpatient,” but it has NOTHING TO DO with where a patient receives care or the kind of care received.
IS A BILLING CODE. Hospitals use it to protect from overzealous auditors and Medicare readmission penalties. May just seem like semantics, but for Medicare beneficiaries,
IT CAN RUIN LIVES. Saddles patients with increased out-of-pocket expenses. Patients who don’t have Medicare Part B are responsible for the FULL COST of the hospitalization.
WHY DOES OBSERVATION STATUS MATTER?
Observation Status can be devastating. It can result in thousands of dollars in hospital bills and thousands more in nursing home bills after a hospital stay.
In 2012 an average hospital stay in the U.S. cost $10,400, and the median monthly cost for a nursing home in the U.S. was almost $8,000.
The use of “outpatient” Observation Status isn’t just wrong, it can be DANGEROUS. Many patients CAN’T AFFORD their care if Medicare won’t pay. If post-hospital care in a nursing home won’t be covered by Medicare, many people GO WITHOUT that care altogether, rather than face the enormous bills. The problem is growing: the number of patients cared for under Observation Status DOUBLED from 2006 to 2014.
Take action at the BEGINNING of a hospital stay to try to stop Observation before it starts.
Ask the hospital doctor to “admit the individual as an INPATIENT” based on needed care, tests and treatments.
Ask the patient’s regular physician to CONTACT THE HOSPITAL DOCTOR to support this request.
FILE AN APPEAL with Medicare, if the patient’s nursing home coverage is denied.
FILE A COMPLAINT with the patient’s state health department, if he/she did not get a notice about “outpatient” Observation Status.
GET AN ELDER ADVOCATE!!!!!!!
Medicaid is complicated.
The Personal Document Locator is a detailed list of where one stores their important records, the contact information for primary advisors, family members, trustees and other important information. The list should be updated at least once a year to ensure its accuracy.
The list will be most helpful in the event of disability or death.
Please contact me at firstname.lastname@example.org should you have any suggestions or comments.
Perry A. Shulman, CPA