<p>“if a kid is dangerous to self or others, then there is a “pink slip” issued by the hospital which means no freedom for three days, a similar kind of legal protection for the institution”</p>
<p>Right, that’s involuntary commitment which requires certain procedures and importantly evidence that student presents a danger. That isn’t to be tossed around lightly. </p>
<p>Being in the medical biz I can assure you that insurances turn down things regularly for being not medically necessary. Your insurance company won’t care what the college policy is, they won’t be paying. And a hospital stay is expensive. There is no way the hospital won’t be billing for this stay. </p>
<p>I’d be really po’d. It’s a waste of medical resources. But beyond that I can give you a personal account of different diseases friends and family have gotten from the hospital - including legionnaires. </p>
<p>I’d be calling and asking their written policy and get assurances today about how they handle stays in hospitals that are deemed medically unnecessary. I’d be calling the hospital as well to get their take on it. Keep an eye out for that eob and let us know.</p>
<p>College’s perspective- win/win. Reduced liability and reduced costs by not having to have MD’s on call all weekend. (Pizza’s husband notwithstanding. My primary care physician is in a large group practice with many covering MD’s and if I get sick on a weekend their advice is the same- head to the local non-emergency clinic which is owned and operated by a big hospital and come in Monday morning to see my doc.)</p>
<p>Hospital’s perspective- win/win. Someone is paying the bill even if they have to eat a portion. Since no medical tests or invasive procedures were performed, they just get compensated for the bed and the jello which would have been empty and uneaten otherwise.</p>
<p>Parent’s perspective- annoyed but grateful that the kid is ok.</p>
<p>The loser is the insurance company but my guess is that a small college, if this happens to 2-3 students PER YEAR, then over a decade, no single insurance company has to deal with more than one of these students (it’s not like every student has the same insurer).</p>
<p>On balance- there is zero incentive for the college to change the policy, and significant costs associated with doing so.</p>
<p>(Deleted, sorry) </p>
<p>Not to get overly dramatic - but even if she’s just sitting there resting and eating jello, that’s still occupying a bed - what if there’s a trauma situation and beds are needed? It’s still occupying nurses’ time that could be better spent on patients who need care. A hospital isn’t like a hotel room, where if I choose to rent it out and sleep there for the weekend that’s my choice. </p>
<p>I am quite confident my health ins co utilization people (who have been informed) will be interested in this. Fwiw, my health ins co is a different company from the one that is part of the student health plan, as we retained our private insurance. Both are major health ins cos. </p>
<p>There should have been a physician to physician phone call between the hospital and your husband, which probably would have made the whole charade unnecessary. Did they call it observation or admission? Your insurance views those things very differently. Keeping an adult in a hospital for 48 hours for a non contagious condition that is not requiring any specific medical therapy but with a vague threat from the school of making life hard for your kid if she doesn’t comply all sounds just so wrong. Glad your daughter is fine and sorry for the trouble, but none of this smells right to me.</p>
<p>There was. My H was all over this from the get-go with both the medical director of the college and the doc at the hospital. </p>
<p>Please call the billing department at the hospital and ask for written agreement that they won’t be billing your insurance for this stay.</p>
<p>Sorry. This just gives medicine a black eye, IMO, but the school seems a little guilty here too. I can’t imaging calling another doc and saying your kid looks fine and is probably going to be OK but whether you agree with me or not, this is what I’m going to do and the prime beneficiary of what I’m doing is me and my hospital. 6 -12 hours of observation? Sure, that’s reasonable, but if no action is required in that time and the pt is fine then it’s most reasonable to dismiss the patient. </p>
<p>Would she REALLY have been leaving AMA?</p>
<p>Or would it have been AUP as in “against university policy”? It sounds like both, or moreso the latter?</p>
<p>The whole thing is fishy, call the ACLU. I mean, I’ll assume that she did not just return from West Africa and was showing a high fever, and I’ll assume that she wasn’t violently ill if she wasn’t really admitted to the hospital.</p>
<p>If the university changed her ID card privileges to try to prevent her from returning to campus, she could have just gotten swiped in on someone else’s card. What would they have done - put out an APB on her to the campus police?</p>
<p>I agree with the analogy that if one of our kids had violent or suicidal ideations expressed to us, and was 18 or older, it would be NIGH IMPOSSIBLE to get them committed against their will. Yet the college just kept her away from the campus “as a matter of policy”?</p>
<p>The fact that your husband was all over this, and you basically (as far as I can tell) had to decide between flying over there IMMEDIATELY at great cost or trying to solve it over the phone, makes it even more egregious.</p>
<p>(I would LOVE if your daughter and her friends protested about the imprisonment on the campus green. That’d show them.)</p>
<p>My guess is that if it is the hospital closest to where Pizza’s D is studying the likelihood that they need the bed for a trauma case over the weekend is extremely low. Lovely suburban hospital which tries to schedule all elective procedures for early in the week; low utilization ER; other than a massive pile up on the turnpike or route 128, there is excess capacity on the weekend. (Wellesley, Needham, Weston, and Newton are not known for gunshot wounds or the other ills of an urban hospital.)</p>
<p>If it is not this hospital- then I am wrong. But the hospital which is somewhat adjacent to this particular campus- sounds like a perfect storm. Extra beds; compliant student; good health insurance.</p>
<p>If my spouse or I were MD’s and in this sort of situation I am sure we would try to play the doctor card to get it resolved. But as a non-doctor, I’ve gotta say it would probably annoy me more if the doctor’s kid could get around this stupid policy and my kid couldn’t. :)</p>
<p>Um…my guess is the doctor will be billing for his services as well. Or the patient will receive a bill for a hospitalist on staff. </p>
<p>It’s not like it’s a hotel where you are just paying for a bed and (bad) food.</p>
<p>When my kid was hospitalized for a week with two surgical procedures, the college was not privy to her stay at all. And yes, she had contacted the dean of students for assistance. The kid was discharged on a Saturday, and all our college wanted to know was what they could do to help her get back on track with her classes. DD did have a medical note with restrictions…but that was it. </p>
<p>I see the cost point Blossom is making. It does cost to run a health center, and outsourcing is probably less expensive. But really…where does the student stand when they are admitted on a Friday and could be discharged the following day? </p>
<p>Guess it’s better to have the families eat those costs than to have an on call doctor at the school? Why is that?</p>
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<p>compmon, you are missing the point completely. The D had no symptoms of anything. She had no medical reason to be sitting in a hospital bed. </p>
<p>There is zero liability to discharge an adult who doesn’t belong in a hospital. On the contrary, it is medically unethical to keep someone in the hospital for babysitting (just bcos she may have no where to go – not the hospital’s problem. </p>
<p>btw: I have to believe that this is not covered under the Affordable Care Act!</p>
<p>Don’t know about MA, but in California, you can only be in observation status legally for 24 hours. After that you’re either admitted or discharged. I can see them discharging her for followup-care at the student health center, but that doesn’t have to be the second she arrives back on campus. It could very safely be the next couple of days. </p>
<p>The hospital is a higher level of care than the student heath center. If the hospital says she can be discharged, why would the Health Center need to second guess that. I think this is bizarre.</p>
<p>I would disagree with Blossom. The loser here is not the insurance company, it’s going to be Pizza’s pocketbook.</p>
<p>Blossom - it is not the hospital I believe you are referring to. Will PM.</p>
<p>“Don’t know about MA, but in California, you can only be in observation status legally for 24 hours. After that you’re either admitted or discharged. I can see them discharging her for followup-care at the student health center, but that doesn’t have to be the second she arrives back on campus. It could very safely be the next couple of days.”</p>
<p>Right. The nature of the agreement is what is interesting to me - that a hospital could have an agreement with an outside party to not release otherwise-releasable patients. Especially of-age adults. </p>
<p>What do summer camps and boarding schools (who are in charge of minors, not adults) do?</p>
<p>I’m curious, what did the health center clearance consist of when she returned to campus on Monday?</p>
<p>A 10 minute intake interview by a nurse asking for a description of the situation and management plan moving forward…</p>
<p>Blue Bayou, I am not missing any points. My example, the one you cited, had me in the hospital with nothing wrong with me. Liability concerns led to doctors keeping me there, even though there was absolutely no cause- and I left AMA. I would have told my kid to leave AMA and stay with a friend in this situation.</p>
<p>The family will not pay for this, the school will. Blossom seems to be the only poster here who gets this situation.</p>
<p>Parents who are physicians, nor not physicians, cannot communicate about the daughter without her permission.</p>
<p>If a student had something going on sufficient to land in the ER or the hospital, and there is no MD to see upon discharge, again, liability concerns would dictate this policy. It may seem ridiculous, and anyone too healthy to put up with it can leave AMA. But this policy will also protect some kids who are truly ill and who want to bolt on their own.</p>
<p>Again, chain of custody. And Blossom outlined why it is a win win for the college and hospital. I would argue that there are occasions when this policy is a win win for students too, and if it does not fit the case of this daughter, she should have signed herself out.</p>