Observation Care is a “hospital status” for patients who are not well enough to go home but not sick enough to be admitted as an inpatient. Observation Care can be done in any area of the hospital and can often be done in a hospital bed overnight and sometimes longer. Medicare rules and regulations determine whether your hospital stay is classified as inpatient or observation status.
You will receive high-quality care from our skilled healthcare team. There is no difference in your treatment, attention, and care. We promise to keep you informed of your condition. We have case managers and financial account representatives at our hospital who can work with you to help you understand how being an observation patient affects your insurance. If at any time, you are unsure about any treatments, tests, medications, or your hospital stay status, please ask a member of your healthcare team. We are here for you. We wish to make your stay as informative and comfortable as possible.
Observation Care is an “Outpatient” service. It’s important that you know, you are not being formally admitted to our hospital as an “Inpatient.” There are differences in how your insurance will cover your stay and ongoing care as an observation patient.
As an outpatient service, Medicare Part B will cover hospital services. That means: You pay a copayment for each individual outpatient hospital service. Medicare Part B will also cover most of your doctor services when you are a hospital outpatient.
You will receive a separate bill from your doctor and the hospital.
Medications: Any prescription and over-the-counter drugs you would be able to take at home are called “self-administered drugs.” If your doctor continues your home medications during your hospital stay, you will likely need to pay out-of-pocket for these drugs. Patients may be allowed to bring regularly taken medications in from home, in accordance with hospital policy. Please ask a hospital employee for more information.
Skilled Nursing Facility: As an observation patient, Medicare will not pay for any extended care that you may want or need in a “skilled nursing facility” following hospital discharge. A skilled nursing facility is often a nursing home. Medicare will only pay for a nursing home stay if you have been admitted as an inpatient for at least 3 days in a row, counting the day you were admitted but not the day of your discharge.
Because your medical needs may change during your stay, your hospital status can change. Depending on test or service results, your status can be changed from observation to inpatient, at any time. It is important that you know whether your stay is an inpatient or observation stay in the event that you and/or your family decide that you need or want to be cared for in a nursing home following your hospital stay. Ask your attending doctor every day what your hospital status is. Any days spent in the hospital as an observation patient are not counted as inpatient days. Inpatient admission has to be consecutive (in a row).
- You are an important member of your healthcare team. Please let us listen to your questions or concerns and help you to the find answers. We want to help make your stay as stress-free as possible.
- If you don’t know, ASK: Observation Care is an outpatient service and payment and financial responsibility are different than inpatient hospital services. Your status can change during your stay. Stay informed so you know how it will affect your financial responsibility as a patient.
- Medicare will not pay for you to go to a nursing home following your stay no matter how long you were here as an observation patient (outpatient). Medicare requires that any stay in our hospital or alternative facilities be medically necessary, outlined by their guidelines.
- Medicare requires you to be admitted for 3 days as an inpatient (not including the day of discharge) in order to cover nursing home placement.
- Days spent in Observation Care do not count toward inpatient days.
- Always DISCUSS your discharge plans with our nursing and case management staff. Our team is dedicated to helping you transition from our hospital to your home.