Observation Status Update

The United States District Court, Western District of New York has ruled that a hospital stay does not have to be covered by Medicare in order for the patient to qualify for post-hospital skilled nursing facility benefits as long as the hospital stay was medically necessary. In this case, the patient was in the hospital for ten days for broken bones in his leg and was discharged to a skilled nursing facility. Medicare was going to deny coverage for both. After several appeals, the courts ruled that discharge to skilled nursing was necessary and Medicare should pay.

This could be a huge step forward for patients who are hospitalized under observation status and need care after discharge. We will keep our readers informed of similar cases