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Outpatient Observation FAQ

1. What is outpatient observation?

Observation is a billing which permits patients who have problems (which normally do not qualify for a hospital stay) to be allowed to stay in the hospital for a “specified amount of time”.

2. What is the difference in billing?

An Observation stay is billed under outpatient services (under Medicare this would be under Part B) while inpatient admission is billed under inpatient services (under Medicare this would be billed under Part A Private Insurances may vary but most permit only 23 hours in observation.

3. What kind of problems do people have that would make observation appropriate?

Problems that can be treated in 24-48 hours or conditions for which the cause has not yet been determined.

4. What are some examples of these problems?

Some examples are nausea, vomiting, weakness, stomach pain, headache, kidney stones, fever, some breathing problems, and some types of chest pain.

5. What is meant by a “specified amount of time?”

Different insurance payors have different amounts of time that are covered in observation.

  • Medicare—observation services cannot exceed 48 hours. Typically a decision to release or admit is made within 24 hours.
  • Medicaid allows up to 30 hours.

6. What happens at the end of the “specified amount of time”?

Your physician will decide whether to release you from the hospital or to admit you as an inpatient.

7. What if my physician decides my condition requires inpatient care?

Your physician must then write an order to convert your outpatient observation stay to an inpatient admission.

8. What if my physician decides that I do not require an inpatient care?

If your physician decides that your care can be performed outside of the hospital you will be released, possibly with home health care services if necessary.

9. Can I be placed into outpatient observation after undergoing an outpatient surgical procedure?

Only if it is medically necessary. Medicare allows for a 4-6 hour “recovery period”. The intent of outpatient surgery is to have your surgery and be discharged the same day. However, if you experience a postoperative complication then your physician may place you into observation to monitor you further.

10. What type of post-surgical conditions may warrant further evaluation in “outpatient observation”?

  • Inability to urinate
  • Inability to keep solids or liquids down requiring IV feedings.
  • Inability to control pain.
  • Unexpected surgical bleeding
  • Unstable vital signs
  • Inability to safely walk after spinal anesthesia

11. What if I desire to spend the night after my outpatient surgery? Will Medicare cover this?

No, Medicare will only pay if there is a medical condition that warrants postoperative monitoring. If you desire to stay over for patient/family convenience, you will be fully responsible for payment.

12. What about “self administered drugs” and other services not covered by my insurance?

  • According to the billing rules for Medicare and Medicaid these charges will have to be billed to the patient.
  • Medicare and Medicaid will not pay for your pills or tablets and even some injectable drugs that fall under the category of self-administered. Please refer to the online version of the National Medicare Handbook at www.medicare.gov or call 1-800-633-4227 if you need more information.

A complete list of deductibles/services covered by observation/outpatient status is in your Medicare and You handbook.

If you would like to speak to someone regarding your financial responsibility as a result of this hospitalization, please feel free to contact our Patient Account Liaisons at ext.7689.

 
CAREER OPPORTUNITIES

Lenoir Memorial enters into management agreement with UNC Health Care

The Board of Directors of Lenoir Memorial Hospital has unanimously voted to enter into a management services agreement with UNC Health Care, hospital officials announced May 16.  Discussions regarding an affiliation began between the Lenoir Memorial board and UNC Health Care leadership earlier this year. The board recognized the extraordinary opportunity to partner with a flagship healthcare leader in the state - defined by excellence in research, clinical advancements and quality of care - was one not to be missed.  It became clear that an agreement with UNC Health Care will best position Lenoir Memorial to create a stronger hospital for the Kinston community for generations to come.

 

"We are excited about our partnership with UNC Health Care and look forward to the vast array of support they will offer us here at Lenoir, said Gary Black, president and CEO. "Our board has been very thoughtful in this process and we believe that this partnership will allow for the growth of services in this community.  UNC Health Care is very much aware of the challenges facing community hospitals in this economic environment and has assured our board that they can assist us in addressing the challenges and maintaining healthcare close to home.  It is our belief that an affiliation with UNC Health Care will best position Lenoir Memorial to continue our mission to ensure exceptional healthcare to the people we serve."

 

Lenoir Memorial employees will keep their current positions and will remain employees of Lenoir Memorial, a private, not-for-profit hospital, not the state.  This agreement does not involve any sale or exchange of assets and will allow Lenoir Memorial to maintain local governance.  "We are pleased to welcome Lenoir Memorial Hospital into our system of 10 hospitals and hospital systems, our physician's networks and our affiliation with the UNC School of Medicine," said William L. Roper, MD, CEO of UNC Health Care.  "This partnership with Lenoir Memorial Hospital will continue our efforts to provide the highest quality care to our patients across North Carolina."


This affiliation will allow Lenoir Memorial to provide a broader scope of resources and experience to benefit its patients.  Some of the primary benefits include:

  • Expansion of locally available hospital and community-based patient care services to enhance patient care.
  • Improved patient experience and satisfaction
  • Enhanced operational efficiency
  • Recruitment of additional highly trained and skilled physicians
  • Access to cutting-edge research and treatments at UNC Health Care
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UNC Lenoir receives bronze

UNC Lenoir Health Care is proud to be participating in the American Heart Association Get With The Guidelines Stroke program.  Participation ensures that our patients are receiving the most up-to-date evidence-based treatment to improve care and outcomes.  Get With The Guidelines Stroke program is an in-hospital program for improving stroke care by promoting consistent adherence to the latest scientific treatment guidelines.  Since its initiation in 2003, 1,656 hospitals have entered more than two million patient records into the Get With The Guidelines-Stroke database.  Numerous published studies demonstrate the program's success in achieving measurable patient outcome improvements. Hospitals receiving the Get With The Guidelines Bronze Performance Award have demonstrated a commitment to treating stroke patients with 85 percent or higher compliance to core standard levels of care as outlined by the American Heart/ American Stroke Association for 90 consecutive days.  "The Get With The Guidelines Stroke program has been a valuable tool for us to use to improve our stroke care.  We are proud to be a part of the American Heart Association's efforts to improve stroke treatment.  Being honored for excellent patient care is the best recognition a hospital can receive," said Dawn Becker, RN stroke program coordinator.  Hospitals also benefit from involvement with access to the most up-to-date research and scientific publications, professional education opportunities, clinical tools, patient education resources, staff support, performance feedback and national recognition for hospital team achievement.

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Be Informed About Mental Health Crisis Resources in Lenoir County

Mental Health Crisis:

24/7 Crisis Services for Lenoir County are available by calling Eastpointe Access Center at 1-800-913-6109 or for TTY-888-819-5112.  Customer Service  Specialists will assist you in finding a crisis provider.

Mobile Crisis Teams are available 24 hours a day.  Professional counselors will speak with you and your family during a visit.  They have an average response time of 2 hours.  This service is provided by Easter Seals - UCP 800-913-6109.

The crisis center in Lenoir County is provided by, PORT Human Services, located at 2901 N. Heritage Street in Kinston.  252-233-2383.  Appointments are not needed for crisis assessment and referral services, Monday - Friday 8 a.m. to 5 p.m.

Suicide:

To be connected to a skilled, trained counselor at a crisis center in your area 24/7 call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255)

The 24/7 National Suicide Prevention Lifeline Network for Lenoir County is provided by REAL Crisis Intervention by calling 252-758-4357 for free couseling and extensive referral services.

Call 911 if there is a medical or life threatening emergency.

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Keep Your Employees Healthy!

Providing onsite flu vaccinations for your employees is one way to prevent absenteeism during the upcoming flu season. Schedule the UNC Lenoir Health Care corporate health nurses to come to your worksite and administer the vaccine to your employees while at work.  Contact Sonia Joyner, RN, MSN Corporate and Community Health coordinator at 252-522-7397 or sjoyner@lenoir.org to schedule your appointment today.  Costs include $25.00 for each flu vaccination ad fees associate with mileage costs and staff administration of vaccines.

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Free Medication Wallet Card

Call the Minges Wellness Center at 252-522-7014 to get your free medication wallet cared and we can mail one directly to your home!  Keeping an up-to-date record of your medicines may help protect you from a mistake.

  • First, it helps you and your family remember all the medicines you are taking.  Next it helps your doctors, nurses, and pharmacists make sure that the medicines prescribed for you can be taken safely together.
  • A list also helps make sure that important medicines you take at home will be continued if you are hospitalized.
  • Finally, your medicine list will help your doctor determine if any illness or symptoms you experience could be related to the medicine you take.

Use a medication list or card to keep a record of all the medicines, vitamins, and dietary supplements or herbs you take.  Keep the list updated and share with your pharmacist and physician.  The medication wallet cards are free but limited to one per person.

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2016 Colorectal Cancer Screening Dates

This free clinic is for men & women age 40 and up who have never been screened for or had colorectal cancer. The clinic will be led by members of the WellAware team and the UNC Lenoir Gastro staff. Screening sponsored by the Lenoir Foundation. Call 252-522-7014 to complete the required registration.

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Free Mammogram Screening - for high risk women

Advanced registration is required to participate in this screening.  Those interested in participating should call 252-522-7014 between 8 a.m. and 4 p.m. Monday - Thursday to schedule their appointment time. Women that qualify receive a free screening mammogram and education about breast self-exam.  To qualify, you must be a woman between the ages of 40-65, have no insurance to cover mammograms, and never have had a mammogram.  Deadline to register is October 3.

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Benefits of Mind/Body Exercise

Tai Chi and Yoga are POWERFUL! Low impact activities that have a high impact on your health! Come learn the history behind these ancient practices. Learn the many benefits:

  • Improved conditions including arthritis, high blood pressure, and relieves chronic pain.
  • Lowers stress
  • Improves balance

Learn how to coordinate your muscles, bones, heart, and mind!  Silver and Fit social immediately follows this class with free light refreshments.

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What Get Measured Gets Managed

Join Brittney Bradshaw at this FREE seminar to discuss or learn more about your preferred food tracker. 

  • Is there evidence that supports technology in tracking exercise and nutrition and what have your experiences been?
  • The number one fitness trend right now is wearable technology and how is the benefit worth the hype?
  • Who should be tracking food in a diary technology?

Get the answers to these and other questions and offer your personal use suggestions!  There are so many, bring your own experiences and learn from others!  Silver and Fit social immediately follows with complimentary refreshments.

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Find Out What’s Cookin in Kinston

Holly White, RD,LDN, will be preparing and offering samples of collards flavored using vegetables instead of meat. Come learn as Holly shares tipsfor preparing healthy dishes using fresh local produce.  

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