He just doesn't look the part, I would never peg to be a homicidal freak just by looking at him.
You beat me to it. I was thinking the same. All it's missing is chunk and sloth.
I enjoy watching Ichiro hit, and I hope he gets into the HOF, but I'm a bit annoyed he still uses an interpreter after 11 seasons in the states.
People fraudulently claim aches and pains through local emergency departments everyday, only to turn around and sell them on the street using their Medicaid coverage to cover the bill for the scripts. 100% profit, the ED visit is covered and the scripts are paid for by the tax payers. This setup was a bit more sophisticated, but same damn thing in the end. This crap needs to stop. Most physicians and pharmacies are starting to use prescription monitoring programs and other tools to manage this population, but there is a lot of work to do.
Now would be a good time to make sure the old bare foot bandit is still in his cell.
You are wrong, I'm on the front line of this kind of work every day. You cleary do not know anything on this topic and you are referring to questionable outdated reference material. You can NOT convert a case from observation to inpatient after 24 hours just because. You have to have a clear case of severity of illness and intensity of service provided. If a hospital tried to do what you are saying, Medicare recovery audit contractors (RACs) would review the case and request the hospital pay back the money that was reimbursed and pay fines.
Length of stay has nothing to do with determining inpatient vs observation status. Observation status can be up to 48 hours. Just because the doctor decides to keep you longer than 48 hours does not mean they can convert you automatically to inpatient. The hospital won't be able to get reimbursement for the additional time. It's called a potentionally avoidable day.
Observation stays are on the rise because every year Medicare keeps coming up with new (tighter)standards on what diagnoses or treatments qualify for an inpatient stay. It is getting more and more difficult to get patients to meet a inpatient level of care. Observation stays are reimbursed less than Inpatient. Plus the rehab care isn't covered. These are some of the cutbacks the government continue to make to cut cost on hospital stays and rehab stays at Skilled nursing facilities. The losers are the elderly who need the rehab care to get back to an independent life, and the hospitals have to keep laying workers off to keep the doors open. Often, hospitals have to take a hit on some of these observation cases because they can't discharge the patient to a SNF, and they are not a safe discharge home. So, after the 48 hours of the observation bill is eaten up, the rest is charity care.
Also, the Care management/utilization department should have caught this case prior to sending her to a skilled nusring facility. Somebody assumed since the patient had been there three nights she was an inpatient, and therefore would have a rehab stent in a SNF payed for by Medicare. Medicare only pays for a SNF stay if the patient has a skilled need and they have met a qualifying three night "inpatient" stay. Sometimes hosptals make mistakes like this, but usually its the hospitals fault and they have to foot the bill. Also, Medicare rules are that the patient has to be informed of their observation status and sign an obsevation letter. in addition, this is why people need a secondary insurance to cover the costs of a part B billing while in a hospital because they can be liable for a 20% co pay if they are without any additional coverage, and have to pay out of pocket for any rehab needs.
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Medley