First off, you do not need to be admitted to the hospital to have tests on your lungs.
She went to the hospital due to the consequences of a fall- not anything to do with her lungs.
They probably did a routine chest xray, and found the spot.
This article is about her not requiring an acute level of care, and the fact that since she was admitted as observation- Medicare will not cover the cost of a nursing home bed.You have to be inpatient level of care for 2 days before Medicare will pick up nursing home costs.
I am willing to bet her relatives did not want to care for her, and that is why they are appealing the observation decision to Medicare.
Her PCP can easily order tests regarding the lung spot as an outpatient.
This was what we call in the medical field a ‘social admit”. Now, Medicare is no longer going to pay for the costs of social admits.
For many years, there were doctors who would admit a patient for three days for "tests" so that the kids could get Mom or Dad into a nursing home for a month or two on Medicare's dime.
"Doctor, what can you do to help us? We just can't care for her any more. We've got to get some decompression time!!"
Medicare has (correctly in my opinion) caught onto this and is threatening both doctors and hospitals with fines and penalties if the practice continues.
Medicare is not intended to provide long term nursing care. If the person is indigent, there is Medicaid. If not, they or their families need to pay their own way.