Blog Hero

When a Hospital Stay Isn’t – Admission vs. Observation

Inquire Today
senior and memory care nurse

By Caryn Tadema, Certified Concierge Care Advisor

George was 90 years old.  He had been a client of mine for 7 years.  We became so close that when he had to leave the assisted living community he had lived at for 7 years, we moved him into our home.

He was getting ready for bed one Saturday night and suddenly fell forward.  It was like watching a movie in slow motion.  I watched helplessly as he fell face first onto the floor with no attempt to break his fall.

After hours of tests it was determined that George went into A Fib and passed out.  He had a concussion, a broken nose and a dislocated shoulder.  He spent five nights in the hospital.  It was recommended that he go to a skilled nursing facility for therapy and rehabilitation after leaving the hospital. However, Medicare would not cover the cost. The reason is that he was not “admitted” to the hospital.  Though he spent 5 days/nights at the hospital, in a patient room, receiving care from Doctors, nurses, therapists, etc.  His status was “Observation,” not “Admitted”.   He did not meet the 3-day hospital stay requirement for Medicare to cover the cost of his much-needed rehabilitation. In addition, his out of pocket medical costs for “Observation,” status were astronomical compared to the out of pocket costs had he been admitted.

Since then, I have seen this happen time and time again.  Insurance Companies are trying to save money, hospitals are trying to avoid re-admission fines, and the consequences are that seniors are being cheated out of the benefits they have spent their lifetime accruing.

The need for an advocate has never been more critical: without it, families are navigating uncharted waters without a guide. Concierge Care Advisors was founded on the mission of advocating for vulnerable adults and their families. Our Services are free to the Seniors we serve. We aren’t hired; we are called to our mission. Please make sure you have advice and help from a knowledgeable professional when a crisis happens so that you and your loved one have the best opportunity for recovery as well as navigation through our complex medical care systems.

 

Written by
Heather

More Articles By
Heather

Our Testimonials

See what families are saying about
Concierge Care Advisors.

Why Choose Us

No Cost for Families

That’s right, our services are free for families! We are compensated by the community we refer to, giving us the opportunity to help any and all families with this journey.

Unbiased
Representation

We take the time to thoroughly vet every community and professional we work with so you receive the quality service you deserve.

Work With
Industry Experts

We’re not just advisors—we’re innovators. We set benchmarks that matter and only work with professionals and communities that meet our standards.

White-Glove Service

You and your loved ones are our focus. From the moment we meet all the way to moving in, we’re by your side every step of the way to ensure your family has the support it deserves.

We Get It Right
The First Time

Start Your Journey

instagram facebook facebook2 pinterest twitter google-plus google linkedin2 yelp youtube phone location calendar share2 link star-full star star-half chevron-right chevron-left chevron-down chevron-up envelope fax