Did you spend at least three nights in the hospital under “inpatient” status, or under observation? It matters if you’re a senior on Medicare who needs rehab after leaving the hospital. Sen. Sherrod Brown has introduced a bill that would allow Medicare to pay for therapy regardless of your hospital status.
The social worker at OhioHealth’s Riverside Methodist Hospital had bad news for Kim Phillips: Medicare wouldn’t pay for the nursing-home therapy that the doctor had ordered for her mom.
That’s because Phillips’ 78-year mother, who fell and fractured her knee cap, didn’t spend three nights at the hospital under “inpatient” status, a federal requirement for Medicare to cover the expense.
The difference between “inpatient” and “outpatient” status can lead to surprise, out-of-pocket costs for nursing-home therapy for tens of thousands of Medicare beneficiaries a year. For Phillips’ family, the bill is approaching $8,000 after 51 days.
It’s a distinction that needs to be changed, advocates say, and Sen. Sherrod Brown, an Ohio Democrat, recently introduced a bill that he says aims to do just that.
“It just makes no sense at all. A hospital night is a hospital night, and we should count all those nights equally,” said Dr. Ann M. Sheehy, head of the Division of Hospital Medicine at the University of Wisconsin, who researches short-stay hospitalizations.
Brown’s legislation, which was introduced last month, would allow Medicare to pay for therapy at nursing homes regardless of hospital status — meaning both inpatient and outpatient nights would count toward the three-night requirement.
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