New problem for seniors who move from a hospital to a nursing home

A growing number of Medicare beneficiaries who are transferred from a hospital to a nursing home are discovering that Medicare won’t pay for the first 20 days of their nursing home stay.

Ordinarily, Medicare covers nursing home stays entirely for the first 20 days as long as the patient was first admitted to a hospital as an inpatient for at least three days. But here’s the problem: A lot of people are discovering that there were never actually “admitted” to the hospital for three days, but rather were in the hospital only under “observation.”

Often, hospital patients often have no idea that they haven’t actually been “admitted” to the hospital. They are given a bed and a wristband, nurses and doctors come to see them, they get treatment and tests, and they fill out a meal chart just as if they had been formally admitted.

Increasingly, hospitals are choosing not to admit patients but rather to place them under observation to determine whether they should be admitted. This is in part due to pressure from Medicare to reduce costly inpatient stays.