Category Archives: Health Care

Hospitals Must Provide Notice About Observation Status

All hospitals must now give Medicare recipients notice when they are in the hospital under observation status.  The notice requirement is part of a law enacted in 2015 but that just took effect.

Signed by President Obama in August 2015, the law was intended to prevent surprises after a Medicare beneficiary spends days in a hospital under “observation” and is then admitted to a nursing home.  This is important because Medicare covers nursing home stays entirely for the first 20 days, but only if the patient was first admitted to a hospital as an inpatient for at least three days.  Many beneficiaries are being transferred to nursing homes only to find that because they were hospital outpatients all along, they must pick up the tab for the subsequent nursing home stay — Medicare will pay none of it.

The law, the Notice of Observation Treatment and Implication for Care Eligibility (NOTICE) Act, did not eliminate the practice of placing patients under “observation” for extended periods, but it did require hospitals to notify patients who are under observation for more than 24 hours of their outpatient status within 36 hours, or upon discharge if that occurs sooner.  The Act required hospitals to begin giving patients this notice as of March 8, 2017.

To avoid violating the law, hospitals that accept Medicare patients will now have to explain to patients under observation that because they are receiving outpatient, not inpatient, care, their hospital stay will not count toward the three-day inpatient stay requirement and that they will be subject to Medicare’s outpatient cost-sharing requirements.  The law does not make hospital observation stays count towards Medicare’s three-day requirement.

Many patients are discharged to a nursing home for several weeks of rehabilitation.  Monthly rates in nursing homes can run in the $10,000 per month range depending on where you are.  If Medicare is paying 100% of the first 20 days, that is a significant benefit.  If not, it can be a significant burden.  Therefore, it is vitally important to understand the difference between being “admitted” to a hospital versus being under “observation” in the hospital.

Power of Attorney for Health Care – How Important is it Really?

Every adult should have a power of attorney.  Powers of attorney work while you are alive, but are incapacitated.  If you become incapacitated and do not have a power of attorney a guardianship proceeding will likely be required.  Such a process is more complex, time consuming and expensive. The study shows, however, demographic disparities playContinue Reading

A Positive Outlook Can Lead to a Longer, Healthier Life

A positive outlook tends to make life more enjoyable than a negative outlook.  Wallowing in pessimism for most people is not the best way to go.  You could say – generally speaking – that optimists have more fun.  But there’s more to being a positive person than simply enjoying life.  There is now some evidenceContinue Reading

Health Care Costs May Gobble Up Social Security Benefits

The average woman could spend an estimated 70 percent of her retirement check on health care costs, according to a recent study by the Nationwide Retirement Institute.  The average man fares better, but still uses nearly half of his benefits to cover medical expenses.  Here’s how the Nationwide analysis reached its disturbing estimates:  It assumedContinue Reading

Signs Someone Might Be Suffering A Dementia-Related Illness

How do you recognize when someone might be operating at a limited mental capacity or has the onset of a dementia-related illness? It can be difficult to acknowledge that a parent is getting older, having remembered them spry and active.  Little things can easily be overlooked as mom or dad just having an “off day.” Continue Reading