UNDERSTANDING YOUR ADMISSION STATUS AT CUMBERLAND MEDICAL CENTER

Coming to the hospital can be a worrisome and confusing experience. Doctors, nurses, and case managers come into your room using medical terminology that you really don't understand. The most frequently misinterpreted terms are those pertaining to admission status.

There are two types of admission status to remember that pertain to hospitalization. The two phrases commonly used are "Observation Status" and "Full Admission." If you are placed in an observation status, this means further testing will take place to determine whether you need to be "fully" admitted to Cumberland Medical Center. Medicare and other insurance companies have criteria that hospitals are expected to follow to help physicians determine which method of admission is most suitable. Typically, observation status lasts for 23 hours or less. It is important to know that some health plans do not cover medications that are taken by mouth while in an observation status. Please be aware of your healthcare plan. One of the most common plans that will NOT pay for oral medications is Medicare. This is a guideline developed by Medicare, not by CMC or any other healthcare facility. Often times, hospitals receive complaints from patients when they receive their bill. These complaints most always pertain to the charges noted on the bill for oral medications. Remember, this is not Cumberland Medical Center’s policy; it is the Medicare guideline that patients be responsible for these medications.

If your physician determines you have the criteria for a full admission, this means he/she expects the care required will exceed 48 hours. This type of treatment can only be delivered in a hospital setting and the patient will require daily evaluation for changes and/or treatment adjustments. If you are admitted as a full admission and your condition improves more rapidly than previously thought, your physician or case manager may inform you your status has changed from a full admission to an observation status. This can work in reverse as well. Often times, patients are admitted as an observation status, with the physician expecting only minimal intervention, but the condition deteriorates requiring an extended stay. At this time, you may be informed by your physician or case manager you are being changed to a full admission.

Upon admission, it is a very good practice as the patient to inquire what your admission status is going to be. This will prevent any questions you could have later on when you receive your bill. You may also ask to speak to a case manager if you are concerned about your admission status while in the hospital. It is the goal of Cumberland Medical Center to answer all questions you may have prior to discharge, therefore alleviating any possible undue stress. If you would like more information about Cumberland Medical Center or any of its services, please feel free to visit our website at www.cmchealthcare.org