Hospital doctors are seniors' best allies in observation stay conflicts, geriatric care group finds

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AMDA issues list of competencies for long-term care physicians
AMDA issues list of competencies for long-term care physicians

Hospital physicians are the best recourse for seniors who have problems related to “observation status,” according to a new survey from the National Association of Professional Geriatric Care Managers.

Despite litigation and legislation aimed at reforming Medicare rules around observation stay, three-quarters of respondents said observation stays are increasing in their community.

More than 80% of respondents said that observation stays are a significant problem in their area. Hospital patients may assume that because they are given a bed and stay overnight that they are considered an inpatient, when in fact they are considered outpatients under observation. This means their time in the hospital does not count toward the three-day minimum needed for Medicare coverage of subsequent rehabilitation or skilled nursing services.

Nearly 80% of respondents said observation stays are causing financial hardship for seniors in their community, and 75% said the issue is causing seniors emotional stress.

Hospital doctors are the best people to turn to if problems arise because of inappropriate classification under observation status, according to 70% of respondents.

“Seniors are being unfairly charged thousands of dollars and denied needed rehabilitation services,” said Jullie Gray, NAPGCM president. “Care managers are having some success in helping seniors avoid this Medicare trap, but the law needs to be changed.”