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22 Hous. J. Health L. & Pol'y 53 (2022-2023)
The Ethical Use of Observation Units: Empowering Physician Autonomy for Patient Placement Decisions

handle is hein.journals/hhpol22 and id is 65 raw text is: 22 Hous. J. Health L. & Pol'y 53 Copyright C 2022 Julie L. Campbell, Kathy Lee, and Emily Mann Houston Journal of Health Law & Policy THE ETHICAL USE OF OBSERVATION UNITS: EMPOWERING PHYSICIAN AUTONOMY FOR PATIENT PLACEMENT DECISIONS Julie L. Campbell, Kathy Lee, and Emily Mann* A B STR A C T ...................................................................................... 56 IN TRO D U CTIO N .......................................................................... 58 I. OUS: WHAT THEY ARE, THE VARIOUS TYPES, AND THE PROS AND CONS OF EACH ..................................................... 62 A. Designated Type I OUs are Considered the Best P ractice ............................................................................... 64 B. Creep in Type IV OUs Reduce the Efficiency and Effectiveness of the OU Care.................................................66 II. REASONS FOR THE INCREASED USE OF GUS...........................67 A. Medicare Rules and their Impact on Hospital Reimbursement and the Patient's Financial Burden..........69 1. The creation of the recovery audit contractors and their impact on patient placement determinations......69 2. The Hospital Readmission Reduction Program (HRRP) and its impact on patient placement decisions......................................................................... 71 3. The Two-Midnight Rule: the final nail in the coffin of physician autonomy over patient placement decisions......................................................................... 73 * Julie L. Campbell is a health law attorney, certified healthcare compliance specialist, medical ethicist and medical-legal scholar. Kathy Lee is a (pending admission) New York attorney, certified healthcare compliance specialist, bioethicist, and legal technology product manager. Emily E. Mann is a corporate health law attorney based in Charlotte, North Carolina.