A hospital could cost your parents their home nursing care benefit.
Lawyers are now looking at the Affordable Care Act to see why some elderly Americans are being hit with some very large bills.
Here is the problem: Under the Affordable Care Act, also called Obama Care, hospitals are penalized for allowing too many patients to return to the hospital within 30 days of their first visit. According to the ABA Journal and the Wall Street Journal, some hospitals are admitting returning patients under “observation status” to keep them out of the statistics that would cause the fine. Patients receive the same care as “admitted” patients but are not classified as such.
Here’s the catch: If you need nursing home care after being released from the hospital, Medicare will not pay the bill. In order to be covered by Medicare, the patient must be “admitted” to the hospital for three days before admission to the nursing home. “Observation status “patients do not meet this qualification. The end result is that the patient has to pick up the bill at the nursing home.
Here is what happened to one couple. Bill Wellentin’s 84-year old wife, Delores, fell down some steps in their backyard and spent four days in the hospital under “observation status.” She then required a two-month stay in a nursing home to continue her convalescence. Medicare did not pick up the tab; not any of it.
The two months Mrs. Wellentin spent in the nursing home cost the couple more than $20,000. The couple had to dip into their savings and retirement to pay the bill.
Some hospitals say they are between a rock and a hard place until the law is revised. That may be some time. The lower Medicare reimbursement of “observation” patients is seen by some as a tax savings.
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