Hoping for some 'observation stay' sanity

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James M. Berklan, McKnight's Editor
James M. Berklan, McKnight's Editor

It was welcome news Tuesday to learn that the confirmation hearing for the person who could officially wind up holding the purse strings for most nursing home payments was civil. Even better was the nominee saying she would look into the ridiculous state of affairs concerning hospital observation stays.

As many a long-term care provider has noted recently, they're getting fleeced by the “Big Brother” in town — the local hospitals. And it's not just LTC providers being hurt. Untold numbers of unsuspecting consumers are being dealt a dirty hand, often getting stuck in limbo because they don't have the prerequisite 72-hour hospital stay they need to get long-term care coverage.

I only have to look across my driveway to see the surviving spouse of a kindly woman who didn't survive long after hospital gamesmanship wound up costing her better long-term care coverage.

Despite lawmakers' introduction of legislation that could clean up the “observation” abuse, the situation has gotten worse, not better, lately.

With hospitals intent on lowering readmission numbers, the use of “observation stay” status has grown. In some instances, individuals have stayed overnight for several nights after significant surgery, and still been recorded as “observational status.”

So all the more power to Sen. Charles Schumer (D-NY) and any others who are pushing to close the observation-stay loophole.

Hopefully, Marilyn Tavenner, who currently is the acting administrator of the Centers for Medicare & Medicaid Services, will soon be peacefully confirmed as the full-time appointee. And then raise hell about the observation stay abuse.

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Daily Editors' Notes

McKnight's Daily Editor's Notes features commentary on the latest in long-term care news. Entries are written by Editorial Director John O'Connor on Monday and Friday; Staff Writer Tim Mullaney on Tuesday, Editor James M. Berklan on Wednesday and Senior Editor Elizabeth Newman on Thursday.


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