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Under Observation – A Costly Concern for FL Seniors

PHOTO: A new report shows a dramatic rise in hospitals with patients under "observation status," raising concerns about quality of care and leading to higher costs for older patients. Photo credit: Avinash Bhat
PHOTO: A new report shows a dramatic rise in hospitals with patients under "observation status," raising concerns about quality of care and leading to higher costs for older patients. Photo credit: Avinash Bhat
November 18, 2013

TALLAHASSEE, Fla. - The number of hospital patients being listed as "under observation" is rising dramatically, a trend that's catching many senior citizens off guard, and leaving them with hefty medical bills.

According to Mary Jo George with AARP, for coverage of some services, Medicare requires a patient to be formally admitted to the hospital, and being there under "observation" status doesn't count.

"If you do not have a three-day hospital stay, what happens is, the Medicare coverage will not cover your skilled nursing care," as she described the situation that can result. "And so, it is pushed onto the senior, who has to often pay large out-of-pocket costs."

A new report from AARP shows that the use of the observation status by hospitals more than doubled between 2001 and 2009, as did the length of time spent in observation, with visits longer than 48 hours increasing the most.

George explained that the growing use of "observation status" also raises questions about the quality of care, but she noted that federal legislation has been introduced to remedy the problem.

"One of the bills in Congress is a bipartisan bill," she said. "It would look to say that the observation services would count toward that three-day hospital stay, so therefore seniors would not have to pay the big out-of-pocket costs if they do need skilled nursing care."

In the meantime, George urges seniors to make sure they're asking questions about their admission status when hospitalized. Patients can also contact their primary care doctor or the hospital doctor treating and ask to be admitted for inpatient treatment.

The AARP report, "Rapid Growth in Medicare Hospital Observation Services: What's Going On?", is at bit.ly/1a9s3CJ. Details on the "Improving Access to Medicare Coverage Act of 2013" are at bit.ly/1asDVPB.

Stephanie Carroll Carson, Public News Service - FL