Question of the Day: "My mother went into the hospital from a fall. When released 4 days later, the hospital told my father that she was "not admitted" only "under observation" for the time there. Why would they do this? Is it something with the billing and Medicare coverage?"

Answer:  Unfortunately this is something more and more elders and their families are running in to.  This does relate to billing and especially the crackdown on hospitals in regards to overpayments for hospital stays.  This was never really intended to be a status for patients for more than about 24-48 hours, but increasingly families are experiencing what yours did with stays upwards of 3-10 days classified as observation status.  This is particularly problematic when a patient needs inpatient skilled nursing care afterwards, because Medicare requires a 3 day hospital stay (with admitted status) in order to cover subsequent rehabilitation or skilled nursing in a skilled nursing facility.  Additionally, the patient may be responsible for some services received during the hospital stay, which is essentially treated as an outpatient stay.

Be aware that Medicare recipients do have the right to appeal coverage decisions.  This is also an important issue for families to be aware of in order to be able to ask questions and get more details when a loved one is in the hospital.  The Medicare coverage (or non-coverage in the case of no qualifying hospital stay) of inpatient rehabilitation can be worth thousands of dollars, and may be key to a loved one’s recovery.

To locate experts in your state who can help you with this elder care matter, go to:

Shannon Martin, M.S.W., CMC
Aging Wisely, LLC
Clearwater, Florida  33756

Member of the national ElderCare Matters Alliance, Florida chapter

Recent Posts

Stay in Touch with Elder Care Matters

 Facebook  Twitter  Google Plus  Linked  Blogger

eNewsletter Sign Up

ElderCare Answers

If you need answers to your elder care questions, send your questions to us at:

Answers are provided by our ElderCare Matters Partners, some of America's TOP Elder Care Professionals who have years of experience in helping families plan for and deal with a wide range of Elder Care / Senior Care Services.

All Q&A's are posted on the homepage of

ElderCare Matters Articles

ElderCare Matters Articles are useful and up-to-date Elder Care / Senior Care articles that are provided by our ElderCare Matters Partners to help you plan for and deal with your family's elder care matters.

If you help familes plan for or deal with elder care matters, then you owe it to yourself and to families across America to become a professional member of the National ElderCare Matters Alliance and to be listed on the many Elder Care / Senior Care Directories that are sponsored by this National Alliance of Elder Care Professionals.

For additional information about professional membership in the National ElderCare Matters Alliance, (including the many benefits of becoming one of our ElderCare Matters Partners) and to download an Application for your Basic, Premium or Partner Membership in the National ElderCare Matters Alliance, visit: ElderCare Matters Alliance.