Costly ending. A new friend who I bonded with over caregiving over our mothers just recently suffered the loss of her husband and it was costly. Her husband had an infection and refused to go to the see a doctor, She could not take his suffering at home along with caring for her mother and called 911. He went to the hospital and refused care. The hospital refused to admit him since he refused care. She refused to take him home so he was discharged to hospice at a SNF where he further refused to eat and receive any medication. There was no prepaid funeral or no time for shifting of community resources even with crisis medicaid planning. The ambulance, hospital visit, and SNF room and board came all out of pocket.

I found this out the hard way recently.. Then they wanted my mother to go to a skilled nursing facility for rehab after discharge, and acted surprised when I said Medicare wouldn't pay because she'd not been an inpatient (which I learned from the paperwork THEY gave me!!) and looked at me like I was being a cheap jerk when I explained I was taking her home because we couldn't afford to pay for the SNF out of pocket (who can???).

Had a sharp learning curve on this nonsense just this month. End result of moms being in "OBSERVATION" while being treated for uti and high ammonia level - nursing home says she has to pay her share of bill (her entire check basically) from day one instead of after 120 days. Advise caution, this is a real issue!

This happened to us last year. After 4 days we were told the status was changing to outpatient. We don't really know what the original status was but were told he was being admitted just like in the article. We had a secondary insurance that picked up the 20% balance, (should have been 100% for inpatient) and fortunately did not need nursing home services this time - usually we do. We panicked until the bills arrived. We do not have the secondary this year as they changed to an "advantage" plan. (That's a joke for another day!) Now we just panic that we'll need another hospital admission and be too afraid to agree. What a needless mess.

Thank you so much for this informative article. Medical care costs can leave the surviving or community-dwelling spouse living a total nightmare of navigating the maze of health care bills that follow a hospitalization. This in addition to grieving the illness or death of their partner is heartbreaking. Unfortunately in this era we must seek to arm ourselves with as much information as we can in order to prevent even more anguish following the hospitalization of ourselves or a loved one. When in doubt always ask the hospital if you or your loved one's status is "admitted". Your financial future may depend on it. Call Medicare if you have any questions.

Thank you. This is very good to know!

Thank you for this information. I knew the observation status is widely used but did not realize the total impact of this status.

This is article is so true. I am going to print it on hard copy and save it.

This is the most useful article I've read in a long time. Thank you!