A new trend in hospitals could cost you and nursing homes thousands of dollars.

If you are on Medicare and spend 3 days (midnights) admitted to a hospital, you will qualify for rehabilitation in a nursing home. Consequently, Medicare will pay the first twenty days, and you will be in a co-pay with Medicare up to 100 days.

However, the trend is, hospitals are under significant pressure from Medicare to fully treat a person once they are “admitted” to the hospital.  There are guidelines that the hospital has to meet basically to ensure that person stays healthy once they are dismissed from the hospital.  Therefore, hospitals are bringing a person in for “observation” for many days rather than admitting them.  To the person in the hospital, it feels as though they are in the hospital.  They are getting care, tests, food, etc. just like a person admitted to the hospital would get.  However, they are not technically admitted to the hospital and therefore do not get the benefit of paid rehabilitation afterwards.

The fear is people are going to think they were admitted to the hospital and then go to the nursing home under rehabilitation only to have Medicare deny payment due to not fulfilling the “3 day” requirement.  These days in the facility with Physical Therapy, Occupational Therapy, Speech Therapy and skilled nursing can cost many hundreds of dollars per day.

The Center for Medicare Advocacy, Inc. had filed a lawsuit regarding this action to help people qualify for rehabilitation if they person spends 3 days, regardless of the label attached to it. 

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