Access Winter 14.15
P. 1
Vol.16, No.4
Caregivers Making a Difference
Pages 4 & 5
Your Link To Community Resources
A Publication of The Area Agency on Aging 1-B Winter 2014/15
Serving the counties of Livingston, Macomb, Monroe, Oakland, St.Clair and Washtenaw
Amazing kids honor elders through
commitment and service
During your next hospital stay, an “admitted” versus “observation” status could impact your Medicare coverage and your expenses
When a Medicare beneficiary is hospitalized, they naturally assume a hospital stay means that they’ve been admitted to the hospital.
Boston University senior Max Wallack,
18, is dedicated to helping older adults,
especially those living with Alzheimer’s
disease. Wallack was age seven when
his beloved great grandmother, Gertrude
Finkelstein, was diagnosed with the disease.
She passed away in 2007 when he was ten. “I always knew that ‘Great Grams’ cared about me deeply. She was my best friend,” he said. Considering that this relationship spanned ten years, the impact Finkelstein would have on Wallack’s life is remarkable.
Wallack visited Great Grams at various hospitals and nursing homes during the last six months of her life. “I noticed that puzzles were a calming activity that provided her with a sense of accomplishment,” said the Massachusetts resident.
Honoring Finkelstein posthumously, Wallack began collecting puzzles to bring that same sense of calm to others battling the disease. The following year, he founded Puzzles to Remember, a non-profit organization that collects and supplies puzzles to facilities that care for those diagnosed with dementia or Alzheimer’s. To date, his charity has delivered more than 35,000 puzzles to more than 2,600 facilities spanning the globe. This widely praised program has been recognized by numerous organizations with over 30 awards.
Max Wallack with his co-authored children’s picture book.
“I remembered how difficult it
was watching Great Grams lose her memories. It’s something I don’t want anyone to go through – ever. That’s why I’m working so hard to change the face of Alzheimer’s disease,” Wallack said. At age fourteen, he became
a volunteer researcher at Boston University’s Health Outreach Program for the Elderly (HOPE), a long term study of memory and aging funded
by the National Institute on Aging.
Last year, Wallack co-authored a children’s picture book titled, “Why
did grandma put her underwear in the refrigerator?” Wallack mentioned that as he grew older, Great Grams seemed to grow younger. “I naturally assumed more of a caregiving role until she
continued on page 2
Traditionally, the term ‘admittance’ means ‘allowed to enter.’ However, in an effort to rein in medical spending while aiming to protect older adults, Medicare is penalizing hospitals for a) unnecessary admissions and b) patients who are readmitted within thirty days of being discharged.
Unfortunately, Medicare’s cautionary measure has given rise to unexpected consequences. Hospitals have pushed back. Instead of automatically admitting patients, hospitals are more often labeling incoming patients with “observation” care, a level of care established by hospitals in the early 1990’s. Essentially this means that you are not sick enough to be admitted, but not well enough to return home.
Adding to the confusion, observation care is often used interchangeably with the term, ‘outpatient.’ Either way, this level of care enables hospital staff to observe the patient’s medical condition for what used to be a 24-hour period of time in order to determine hospital stay status. Now observation status can continue for days. This decision is made by the attending physician, though the hospital has the final say. This status can also change from observation
to admittance and admittance to observation at any time during the hospitalization.
However, according to the Center for Medicare and Medicaid Services, there’s been more than a 300% increase in hospital observation care stays beyond 24 hours, nationwide, from 2006 to 2010.
This verbiage has created serious financial consequences for Medicare consumers because the classification of a hospital stay affects how much the patient pays. For example, Medicare Part A covers claims for hospitalized patients classified as admitted and Medicare Part B covers claims for patients classified as observation care/ outpatient. So Medicare beneficiaries who’ve enrolled in Part A, but not Part B, would be responsible for the entire hospital bill if that hospitalization was classified as observation care/outpatient, and that also means paying out of pocket for medications, lab tests
and x-rays.
In addition, Part A will only cover
a subsequent stay at a skilled nursing facility if the hospitalized patient is classified as admitted for at least three consecutive midnights at the hospital. Time spent classified as observation care doesn’t count toward meeting this requirement.
Metro Detroit resident Irene
Kolynuk experienced this first-hand
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Inside This Issue
Ask the Expert ........................................3
In-Home Service Caregivers ..................4
2014 Caregiver Expo ..............................7
Deliver a Holiday Wish in a Home DeliveredMeal ......................................8
National Family Caregivers Month ..........8
Tips on How to Insure an Admitted
Status During a Hospital Stay ..................8
Area Agency on Aging 1-B
29100 Northwestern Hwy., Suite 400
Southfield, MI 48034 PAID

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