Hospitals Caught Between a Rock and a Hard Place Over 'Observation'
She couldn't walk, didn't speak like she usually did, and was unable to finish sentences. "Her words just trailed off," Lubrant says.
With an underlying diagnosis of subcortical dementia, she didn't meet evidence-based criteria for admission, Lubrant said.
In March, there was a similar incident. Her mother woke up unable to move her legs or perform three activities of daily living. She was taken by ambulance to ISJ, given tests and X-rays and a variety of physical therapies. "We were told it was just normal aging," Lubrant said, keeping her frustration under control.
Then when her mother was ready for discharge, Lubrant recalls, the family was told that her mother was never admitted, and therefore not qualify for Medicare benefits, and would have to pay the nursing home bill privately. Worse, they had no rights of an appeal that an inpatient has.
I know there's a reason why policies like observation status designation exist. We must make sure that over-eager hospitals, perhaps those with poor diagnosticians or those with low census, don't admit patients who don't really need to be there.
But the growth in the number of observation status patients—without a corresponding reason—should tell us that this is a problem that sorely needs fixing.
Hopefully, CMS is working on it. But as of this week, CMS' Griffith says, there is "nothing new to report."
Cheryl Clark is senior quality editor and California correspondent for HealthLeaders Media. She is a member of the Association of Health Care Journalists.
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