Macaroni KID Pasadena-Severna Park-Glen Burnie and Assisted Living Locators in Annapolis are pleased to bring you the second article in our monthly Sandwich Generation article series we launched in April. Hospital stays are a common situation for loved ones in the Sandwich Generation, and this article discusses information you might need to know regarding admitted and observed hospital stays, along with other important information.
This article is sponsored by Jennifer McAndrews of Assisted Living Locators in Annapolis. Contact Jennifer to help you and your family find the right care option for your loved one!
Other topics in our series of five articles include what happens upon hospital discharge, how to decide on assisted living, estates and wills, and more. Find our first article HERE, about Laura's experience in the Sandwich Generation, when she cared for her ill father and her young child at the same time.
The sandwich generation as defined by Merriam-Webster is, "a generation of people who are caring for their aging parents while supporting their own children."
To help us understand the differences between admitted vs. observed hospital stays, we spoke to a representative at Luminis Health Anne Arundel Medical Center in Annapolis. She also shared other information helpful for adult children in the Sandwich Generation.
The representative shared these important pieces of information:
1) Definitions of admitted vs. observed hospital stays. An admitted stay is considered to be an inpatient visit. An observed stay is considered to be outpatient, and those patients typically leave 24-48 hours after arriving at the hospital.
However, everybody gets same level of care, whether your loved one is in the hospital for an admitted stay or observed stay.
2) Billing. The main difference between the two types of stays is the billing.
The two types of stays are billed differently through Medicare: admitted patients usually have a $1500 copay and observed patients are billed at 80/20.
3) Rehabilitation after a hospital stay. The purpose of rehab is to get back to the previous level of ability.
To qualify for discharge to a rehab facility, a patient must be in the hospital for at least 3 days as admitted status among other qualifications. Patients who do not qualify CAN still chose to go to rehab, although it will be via the "private pay" route, which is the range of about $400 a day. Either way, you should always check with Medicare (or any other insurance providers) to verify what is covered.
There are occasions when an admitted patient has stayed for 3 days (or beyond) but is still not a candidate for rehab. In these cases, it has been determined that the patient's situation will not improve by going to rehab. It is at this time that other options may come under consideration such as home health care, non-medical home care and/or hospice care.
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4) Have a plan with an advanced directive.
As stated from the Maryland Attorney General's Office, "An advance directive allows you to decide who you want to make health care decisions for you if you are unable to do so yourself. You can also use it to say what kinds of treatments you do or don't want, especially the treatments often used in a medical emergency or near the end of a person's life."
Our representative stressed that planning with your family is key and to have discussions with your loved ones about their needs.
5) Parents should designate one child to make decisions for his/her parents while in the hospital. Case managers prefer to work with one child, not more than one.
Furthering the need for an advanced directive, case managers often have to deal with situations where siblings give conflicting information and/or authorizations to hospital staff, which creates confusion and frustration. Moreover, sibling in-fighting can create delays, which could cause delays in critical treatment for their parents.
6) Custodial Care. Custodial care is care that patients need that is not skilled, is provided at home and does not qualify the patient for an extended hospital stay or rehab. These needs include tasks such as housework, meal preparation, personal hygiene, transportation to appointments and anything else that would be considered activities of daily living. Medicare and insurance do not cover custodial care expenses.
This is the point where many patients and families feel frustrated, because although mom or dad are not candidates for rehab, they are not prepared to go home and handle the current situation just yet that they have found themselves in.
Find out more on custodial care and other issues in our third article in the Sandwich Generation Series entitled, "What Happens Upon Discharge?" Look for it in late June.
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As the owner of Assisted Living Locators Annapolis, Jennifer McAndrews provides a no-cost, placement and referral service that offers the best senior care options, information, and resources available. She has dedicated her career to serving seniors which includes experience as a home care agency owner for 13 years. Jennifer joined Assisted Living Locators to assist families navigate the ever-changing demands of caring for an aging loved one.
Contact Jennifer to help you and your family find the right care option for your loved one!
Jenm@assistedlivinglocators.com
