Observation Stay

Largest US hospital chain to pay $98 million in observation stay case

By

The nation's largest hospital organization has agreed to a $98 million settlement to resolve charges that it overbilled by admitting individuals as inpatients rather than keeping them under observation, the Department of Justice announced Monday.

Falling short in labeling seniors

Falling short in labeling seniors

By

I'm confident I'm not the only person who has worked in a hospital or long-term care who has heard this conversation about someone elderly who has recently died. "Well, she fell and broke her hip a few months ago," Person A says. Person B shakes her head and says, "Well, after that, it's all downhill."

Hospitals slap the government with lawsuits over 'two-midnight' policy to reduce observation stays

Hospitals slap the government with lawsuits over 'two-midnight' policy to reduce observation stays

By

The American Hospital Association and other hospital groups have sued the federal government over the so-called "two-midnight rule," which was designed in part to ease access to skilled nursing services. The rule undermines the judgments of physicians and other clinicians, the hospital associations stated in their complaint, filed Monday in U.S. District Court.

As cameras roll, providers raise hopes about hospital 'observation' stays

As cameras roll, providers raise hopes about hospital 'observation' stays

By

It's been said for a long time that a picture is worth a thousand words. Moving pictures? Start multiplying the worth. Add some sound or speaking to those moving pictures, well now we're talking really, really big impact. Long-term care providers are hoping so.

60 seconds with ... Michael A. Ross, M.D.

60 seconds with ... Michael A. Ross, M.D.

By

Q: You co-authored a study on how specialized hospital observation stay units could increase transparency and allow quicker inpatient admission decisions. This would help people meet the three-midnight requirement for skilled care. What are the characteristics of type 1 unit care?

Dedicated observation stay units could protect nursing home benefits, save hospitals $1 billion annually, researchers say

Dedicated observation stay units could protect nursing home benefits, save hospitals $1 billion annually, researchers say

By

Specialized hospital units for patients under observation status could dramatically reduce the number of seniors forced to pay out-of-pocket for skilled nursing care, according to findings in the current issue of Health Affairs.

Bizarre decision shows that when it comes to 3-day stay rule, there ought to be a law

Bizarre decision shows that when it comes to 3-day stay rule, there ought to be a law

By

There are many odd animals roaming our healthcare industrial complex. But few are more bizarre than Medicare's three-day rule. Or more deserving of extinction.

Kill inpatient eligibility requirement for skilled care, former CMS chief Berwick says

By

The former head of the Centers for Medicare & Medicaid Services has said the agency should scrap a rule requiring three days as a hospital inpatient to qualify for Medicare coverage of skilled nursing care. Long-term care advocates praised the statement.

OIG finds 'observation stay' problems, calls for reform

OIG finds 'observation stay' problems, calls for reform

By

Long-term care groups are among those hailing a federal study that raises critical questions about hospitals' apparent over-use of "observation stay" designations for patients.

Progress in the hospital 'observation stay' chaos

Progress in the hospital 'observation stay' chaos

By

When you complain about bizarre government conditions or regulations, as columnists are wont to do, you usually have to assume you're just whispering into a stiff wind. But now comes word that no less than the Office of Inspector General of your Department of Health and Human Services is jumping on the bandwagon to change the hospital "observation stay" madness.

Progress in trying to undo the hospital 'observation stay' mess

Progress in trying to undo the hospital 'observation stay' mess

By

What is this world coming to? When you complain about bizarre government conditions or regulations, you usually have to assume you're just whispering into the wind.

Observation stay case debated in court

By

Government lawyers and opponents of Medicare's "observation stay loophole" recently squared off in federal court, when a judge convened the first hearing in the Bagnall vs. Sebelius case. Richard Bagnall and other seniors denied Medicare coverage for skilled nursing care brought the case in 2011.

Medically Complex Medicare Part B

Medically Complex Medicare Part B

By

While CMS tries to figure out how to proceed with the manual medical review process, we continue to track our caps and apply our modifiers. In the meantime, has anyone noticed how our typical Medicare Part B patients have become more medically complex than just a few years ago?

Observation stay challenge heads to court

By

Government lawyers and opponents of Medicare's "observation stay loophole" squared off in court on Friday, when a federal judge convened the first hearing in the Bagnall vs. Sebelius case.

Looking to open eyes about 'observations'

Looking to open eyes about 'observations'

By

Bully for provider groups pulling out the stops to draw attention to the ludicrous mishandling of "observation stay" designations by many hospitals. One prong of the plan is to have providers supply anecdotes about individuals hurt financially and emotionally by the practice.

Hoping for some 'observation stay' sanity

Hoping for some 'observation stay' sanity

By

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.

Beware of hospital observation loopholes

Beware of hospital observation loopholes

By

Hospitals have been undergoing more and more restrictions on re-admissions and are now facing financial penalties in some situations. Unfortunately, this has also resulted in more patients not being classified as "admits" or "re-admits," but rather getting coded as "observation" stays.

CMS should modernize hospital admission status policies, say provider groups

By

Provider groups assert regulators should update existing policies when determining hospital inpatient and outpatient admission status.

Provider group pushes for observation stay loophole fix

By

A long-term care group is urging regulators to continue work on fixing the "observation stay loophole" that makes it harder for Medicare beneficiaries to get nursing home care.

Lawmaker touts legislation fighting 'observation stay' Medicare loophole

Lawmaker touts legislation fighting 'observation stay' Medicare loophole

By

Proponents of a bill to cut out the "observation stay" Medicare loophole got a boost from a House of Representatives member Wednesday.

Hospitals increasingly use 'observation stay' loophole, data shows

Hospitals increasingly use 'observation stay' loophole, data shows

By

Physicians and hospitals increasingly are admitting more Medicare beneficiaries for observation stays rather than as hospital inpatients, new research concludes.

Don't miss any McKnight's news

Featured Articles