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What does it mean to have observation beds?
An observation bed is where the patient is placed to be observed by providers and nurses when they are not well enough to go home or they don’t meet the criteria to be admitted to the hospital. When a patient is in “observation status” it means the physician will monitor the patient’s condition and make a decision on whether the patient can go home in less than 24 hours or will need to be admitted to the hospital to continue to receive additional care. If the patient needs additional care beyond 24 hours, the patient will then be transferred and admitted to an inpatient facility.
Who determines the rules and regulations for observation beds?
The Centers for Medicare and Medicaid services determines what rules and guidelines all medical centers must follow to determine whether a patient’s condition qualifies for inpatient (hospitalization) or observation status. Observation care is considered an outpatient, unscheduled service even though you are still at the medical center. Even if you remain in the facility overnight, you will still be considered in observation status, which is considered an outpatient service.
Why are certain patients placed in “observation status” instead of admitted to the hospital? Doesn’t this just cause the patient and family more uncertainty?
A patient is placed into observation status based on specific criteria of the severity of the patient’s illness and condition. In some cases it is not immediately clear whether a patient is well enough to go home or if hospitalization is necessary. In these cases the care team needs additional time to observe the patient to ensure they receive the appropriate care at the appropriate time. Although this takes time, it’s the right thing to do for the patient.
Where will the observation beds be located on the Albert Lea campus?
There will be four observation beds available on the Albert Lea campus located within close proximity of the Emergency Department. The four beds will be in a private area where family will be allowed to be with their loved one as needed prior to being discharged home or admitted to the hospital if needed.
How will the observation beds area be staffed?
The care to our patients will be provided by highly skilled staff such as providers, nurses, and other allied health staff. On observation status, the seriousness of your illness or condition is reviewed while you continue to receive care in the Emergency Department or the hospital setting. The care team will continue to evaluate your status while you are at the medical center and will decide whether you need to stay in observation care until you leave the medical center (less than 24 hours), or if your status needs to change to being an inpatient (admitted to the hospital).
How will the patient be billed if they are in observation status vs. being admitted to the hospital?
Billing will vary depending upon each patient’s specific medical condition/illness, and the patient’s insurance coverage. We recommend that you contact your insurance carrier directly to confirm your coverage when placed in Observation status. To better understand observation care or your status, contact:
- Your insurance provider.
- Office of the Ombudsman for Long-Term Care: 651-431-2555 or 800-657-3591; TTY: 711.
- Office for State Managed Health Care Programs: 651-431-2660 or 800-657-3729; TTY: 711.
- Beneficiary and Family Centered Care Quality Improvement Organization: 866-433-3658.
If you have questions about billing and your hospital stay, call 1-844-217-9591.
If a patient has Medicare, what is covered if the patient is placed in observation status?
When a patient is placed in observation status it means they are covered under Medicare Part B services, rather than Medicare Part A, which only covers inpatient (hospitalization) services. Although the patient is in a room and bed, and receives similar services to inpatients (those who are in the hospital), the patient is not considered an inpatient (a hospital patient) under Medicare Part B guidelines. It’s important for the patient and their family members to understand what is covered and what is not during an observation stay to ensure there are no misunderstandings. For questions regarding what is covered under Medicare, the patient and family is encouraged to talk with the care team, including social workers, to help you understand the coverage you can expect, or contact Medicare or your insurance company for additional coverage information.