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Update on "Observation Status": New York State's Small Step in the Right Direction

On January 19, 2014, New York’s Observation Status Law went into effect requiring all hospitals to inform patients who are assigned to observation status that they are not admitted to the hospital, but are under observation status. Verbal and written notification is required within 24 hours of assignment to observation status.
WHY IS THIS IMPORTANT?

Your hospital status (whether the hospital considers you “inpatient,” as when you’re admitted or “outpatient,” as when you’re placed on observation) affects how much you pay out-of-pocket for hospital services like x-rays, drugs and lab tests.  It may also affect whether Medicare will cover the care you get in a skilled nursing facility. As the law stands right now, Medicare will only cover the cost for rehabilitation care at a SNF for those hospital patients who have actually been admitted for 3 days, and observation status days do not count.

How can you prepare and protect yourself in the event of a hospital stay?

  • If you have a planned, non-emergent hospital visit, be sure to understand your diagnosis and prognosis, ask if there will be follow-up care and if that care is likely to occur at a skilled nursing facility.
  • If you are placed on “observation status” and have concerns, speak to your primary care physician and/or the hospital’s patient advocate.  Also contact Medicare (and any other insurance plan you may have) to see how observation status may affect your coverage.
  • Always be sure to convey (or prepare your health care proxy to do so) the history and complexity of your health condition to the medical staff upon arriving at the hospital.
  • Be sure to inquire about your status each day throughout your hospital stay, as it can change.

More questions?

The StateWide Senior Action Council operates the Patients Rights Helpline ((800) 333-4374) to help inform people about their hospital rights. The hotline can explain the options and ramifications for patients classified as “observational.”  More information is also available at http://www.nysenior.org
 

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