Who Cares.

     I've  received 2 calls, so far, from medical offices asking if I'd scheduled follow-up visits, which I had not. I mean, enough is enough. So I asked, at the second call, why I was being asked. I didn't say hounded or anything. The caller said that it was insurance company,  that if I ended up back in the hospital, they "would be in a whole lot of trouble."
    I have come to understand that the Medicare Readmission Program team cares deeply about my health.
   I must add that the local hospital now makes it very clear indeed, on Form CRM-018SAM, exactly what the patient's status is. The form,  called Medicare Outpatient Observation Notice, newly revised, as of 6/15/17, lets the patients know that being  told they're being "admitted,"  doesn't mean they're being "admitted," not really. That's Medicare language. If you've  ever wondered why so many patients are  discharged from the hospital by the third day, not counting the day of discharge, it's because any longer admissions could result in increased financial obligations on the part of Medicare. So if you know of any elderly patients being retained in hospital for more than the 3 days' admission, they are in serious medical trouble. 
   On the other hand, judging from experience, it seems that hospitals are willing, and even eager, to "admit" patients for up to the 3 days threshold, even if the patient is not eager to be there. 
    Last year, when Patient D. was conveyed to ER by ambulance for a fall that stunned him and lacerated his head, he was transferred from St. Mary's to Samaritan for admission. He was assigned therapists and given referrals to choose an in-patient facility for an unspecified period of time. Then, unexpectedly, was told he was being discharged to home, and if he was there longer than the third day, he would be responsible for hospital charges, estimated at $2,000 per day. Patient could appeal, but if appeal was denied, charges would be owed. However, at the time, the packet of literature in the patient's room said otherwise, that those charges would not be patient's  responsibility. After denial of appeal, despite several phone calls from various family members, a letter with attached (evidently defunct) hospital policy submitted to Medicare resulted apparently in no cost to patient for the "extended visit day."  So now the hospital has a new form to cover any such circumstance.
    A minor win, but if patient D had been admitted for 3 days, nursing home costs would have been covered, so Medicare wins bigger.