Observation Status Continues to Be a Growing Problem for Medicare Beneficiaries

Many Medicare patients who require skilled nursing care after a
hospital stay are often surprised when they receive a very expensive bill for
the skilled nursing care. Medicare beneficiaries can be held as “observation”
rather than as an admitted patient even though it may appear to the patient to
be a regular stay in the hospital. Medicare will not pay for the subsequent
skilled nursing care if the patient’s hospital stay is classified as
observation. Learn more.

A new investigation shows that whether a Medicare patient is
admitted to the hospital or kept for observation depends on what hospital they
go to, even when symptoms are similar. In 2012, Medicare beneficiaries had 1.5
million observation stays and commonly spent one night or more in the hospital.
The investigation suggests that CMS consider how to ensure that beneficiaries
with similar post-hospital care needs have the same access to and cost-sharing
for SNF services. Learn more and read a memo from CMS on observation status.