There is a Medicare rule that a beneficiary must spend 3 days in the hospital prior to being admitted to a nursing home. This rule has left many seniors with denied claims and large out of pocket costs. If a hospital does not admit a person but holds them for observation the clock does not start ticking on the 3 days. Seniors are very frustrated by this.
For example if someone is held for observation for 24 hours and then admitted for 48 hours they have only spent two days in the hospital. If they are transferred to a nursing home the after the 2 day stay that nursing home stay will not be covered by Medicare.
The number of observations patients ineligible for Medicare-covered nursing home care has shot up by eighty eight percent in the last 6 years to 1.8 million in 2012.
Only Congress can change this rule. As always we encourage you to contact your local Legislatures
regarding changes to laws that are important or may impact you.
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