KHN Morning Briefing

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Medicare Beneficiaries In Observation Care May Face Surprise Hospital, Nursing Home Bills

A Modesto Bee article examines the costs for one woman. Also, KHN reports on problems with a Medicare program designed to help poorly performing nursing homes.

The Modesto Bee: Medicare Patients Who Were Under ‘Observation’ Are Stung By Hospital Bills
Jane Hardin of Modesto said her 91-year-old mother was in the hospital with severe shoulder pain last month and then was placed in a nursing home for medical rehab. A big surprise came when her mother received a letter from her Medicare health plan saying the hospital bills were not covered. Hardin learned her mother was on “observation” status in the hospital and was classified as an outpatient, even though nurses and doctors attended to her in a hospital bed and ran tests, and she stayed overnight in a hospital room. (Carlson, 7/6)

Kaiser Health News: Half The Time, Nursing Homes Scrutinized On Safety By Medicare Are Still Treacherous
In 2012, Parkview Healthcare Center’s history of safety violations led California regulators to issue an ultimatum reserved for the most dangerous nursing homes. The state’s public health department designated Parkview, a Bakersfield, Calif., nursing home, a “special focus facility,” requiring it to either fix lapses in care while under increased inspections or be stripped of federal funding by Medicare and Medicaid .... While special focus status is one of the federal government’s strictest forms of oversight, nursing homes that were forced to undergo such scrutiny often slide back into providing dangerous care, according to a Kaiser Health News analysis of federal health inspection data. Of 528 nursing homes that graduated from special focus status before 2014 and are still operating, slightly more than half — 52 percent — have since harmed patients or put patients in serious jeopardy within the past three years. (Rau, 7/6)

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