Hospitals Caught Between a Rock and a Hard Place Over 'Observation'
Observation was supposed to be limited to 24 or 48 hours, so clearly many hospitals want to keep the patients close by in the belief that they may be too sick to go home, but too healthy to qualify for a RAC-free admission.
Tarasovitch says that between 2008 and 2009, ISJ's observation days "have risen considerably. We have to do the right thing for the right reason," he says.
But still, the complaints from family members have risen as well. There have been three so far this year from families with concerns such as those expressed by Lubrant, who've been saddled with bills they didn't think they deserved, and certainly didn't expect, he says.
"Their frustration levels are getting higher and higher," he says, "and we're caught in the middle."
Nationally, the complaints are rolling in to Toby Edelman, an attorney with the Center for Medicare Advocacy in Washington, D.C. Every day, it seems, she gets yet at least one more complaint from a weeping family members over bills they never thought they'd have to pay because Medicare would always be there.
"The cases don't seem to stop," Edelman says. She adds that at long last, there's one issue on which hospital officials, advocates, and skilled nursing homes agree with family members and patients. There has to be a way to put a limit on the number of days a patient can stay in the hospital, after which the patient must be admitted, so follow up care won't break the family bank, and hospitals can be paid for the quality care they deliver, she says.
From Sandi Lubrant's perspective, the situation has been a nightmare not just for her, but for her father who recently suffered a stroke.
The last time her mother was taken to the hospital just a week ago, "she had fallen after dinner while throwing bread crumbs to the birds, and hit her head on the door jamb and then the floor, resulting in a goose egg-sized knot on her forehead and concussion."
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