Observation Status Challenge Tool

Step 1 of 3

Tell me about the stay

Nothing you type here is sent anywhere. It all stays in your browser.

Is the patient still in the hospital right now? Yes, still in the hospitalThis is the best time to act. Most of these rights are strongest before discharge. No, already dischargedYou still have options. They look different, and some have deadlines. What kind of Medicare coverage does the patient have? Original MedicareRed, white and blue Medicare card. Often with a separate supplement or Medigap plan. Medicare Advantage (Part C)A card from a private plan such as Humana, UnitedHealthcare, Aetna or Blue Cross. I am not sureThat is very common. I will tell you how to find out in the next five minutes. This is the question everything turns on. Which one happened?

Observation is a billing designation the hospital uses to get paid by Medicare. It is not a statement about how sick the patient is. People with fractures, after surgery, and seriously ill have all spent days in a hospital bed under observation. Being in a regular room, having tests, and staying several nights does not mean the patient was ever admitted as an inpatient. Only a doctor's inpatient order does that.

Admitted as an inpatient first, then switched to observationSomeone told you the status was changed, or you got a Medicare Change of Status Notice. Under observation the whole time, never admittedYou may have received a Medicare Outpatient Observation Notice, called the MOON. I do not know which oneMost families do not. Step 2 gives you the exact words to ask.

How many nights in the hospital so far?

Date the stay began

Patient's full name

Patient's date of birth

Hospital name

Room or unit number

Attending physician's name, if you know it

Medical record or account number, if handy

Who is filling this out? I am the patient I am a family member or the patient's representative

Your name

Your relationship to the patient

A phone number the care team can reach you at In your own words, what worries you about this stay?

One or two sentences. This goes into the letter, so write it the way you would say it out loud.

Step 2 of 3

Where you stand

Step 3 of 3

Your documents

Read them over, change anything that is not right, then print or copy them. You are the one who knows this patient.

1. Status challenge letter

Hand a paper copy to the attending physician or the charge nurse and ask for it to be placed in the chart. Give copies to the people listed at the top.

2. What to ask for, and how to log it

Write down every name, every time. A dated log is what turns a hallway conversation into something reviewable later.

3. Question script for the care team

Ask these out loud, in this order. Read them off your phone if that is easier.

Want this on a computer so you can print it?

Send yourself a link that reopens this page with everything you typed already filled in. Open it on a computer, then download the PDF and print it.

Your email address

This opens your own email app. Nothing is sent to Nash Patient Advocacy and we store nothing. But what you typed travels inside that link, so that email will sit in your email account like any other message. Treat it the way you would treat a piece of paper with the same information on it.

Nothing happened when you clicked?

That usually means this device has no email app set to open on its own, which is normal if you read mail in a web browser. Any of these will work instead.

If you copy, paste it into a new email to yourself, or into a text message. It works the same way.

The PDF is built on your device. Nothing is uploaded. It carries the Nash Advocacy heading and my contact information on every page, so whoever you hand it to knows where it came from.

Please read this part. This tool gives general education about Medicare hospital status, not legal advice, medical advice, or a guarantee of any outcome. Rules change and individual situations differ. It does not create an advocate-client relationship. Always confirm current requirements with the hospital, with the patient's plan, or with 1-800-MEDICARE.

Tell me about the stay

Where you stand

Your documents

1. Status challenge letter

2. What to ask for, and how to log it

3. Question script for the care team

Standing in a hallway and not sure what to do next?

This is an education tool, not advice