UMC Health System
Last month I gave a presentation on Medicare and a good portion of the discussion afterwards were questions, wanting to know the difference in an observation stay and an inpatient stay in the hospital. This month I will try to explain the difference, and how it affects the way Medicare bills you and pays the hospital.
An observation stay while in the hospital is always treated as an outpatient hospital stay. During your stay, you received medical services that helped the hospital doctor decide whether you should be admitted to the hospital as an inpatient or discharged.
Let me explain how this works. Observation stays may occur if you go to the emergency room and a doctor has to monitor your symptoms. While the symptoms are monitored, the doctors decide whether you should be admitted into or discharged home.
For those with Medicare you are an outpatient during an observation stay even if you stay in the hospital overnight.
While observation stays may seem like inpatient hospital stays, staying in the hospital overnight does not automatically make you a hospital inpatient. You are only considered an inpatient if you have been formally admitted into the hospital as a hospital inpatient by a hospital doctor. If you have not been formally admitted into the hospital as an inpatient, you are considered an outpatient. In general, doctors will admit you as a hospital inpatient if they expect you will need to stay at least two days overnight in the hospital.
So, why is this important to those on Medicare? It is important because Medicare Part A, the hospital insurance part of Medicare, covers inpatient hospital stays. If you get your Medicare benefits through Original Medicare, the traditional
Medicare program administered directly by the federal government, Part A covers most inpatient hospital care you receive during your stay. In general, you or your supplemental insurance plan pays a one-time deductible for your hospital stay.
After you meet the deductible, you do not have to pay a copayment for the first 60 days of your inpatient hospital stay.
Remember, a deductible is the amount you pay out of your own pocket for health care services you receive, before
Medicare starts to pay for some of the cost of your care. A copayment, or copay, is the set amount you pay for care you receive, after Medicare pays for some of the cost of your care.
On the other hand, Medicare Part B, the medical insurance part of Medicare, covers outpatient care, such as health care services you receive while you are under observation in the hospital. If you have Original Medicare, Part B covers outpatient services you receive. If you are under observation in the hospital, you typically pay a 20 % coinsurance for each medical service you receive in the hospital after you have met your yearly Part B deductible. A coinsurance is the percentage amount you pay for care you receive, after Medicare pays for some of the cost of your care.
If you get your Medicare benefits through a Medicare Advantage plan, also known as a Medicare private health plan, different costs and rules may apply. Contact your plan directly to learn more about your plan’s coverage of hospital care.
It is important to know whether you are considered to be a hospital inpatient or outpatient since your Medicare costs and coverage may differ depending on your status, because your costs may be higher if you are a hospital outpatient.
If you are in the hospital, you or your family member should ask hospital staff whether you are an inpatient or an outpatient each day during your hospital stay, since this affects what you pay for hospital services. Keep in mind that whether you are an inpatient or outpatient can also affect whether you will qualify for Medicare coverage of skilled nursing facility care. If you have Original Medicare, Medicare will pay for skilled nursing facility care only if you have been in the hospital as a hospital inpatient for three nights in a row. Again, costs and rules may differ if you get your Medicare benefits through a Medicare Advantage plan.
In review, if you stay overnight in the hospital, your costs and coverage will depend on whether you have inpatient status or outpatient status in the hospital. Know that staying overnight in the hospital does not make you a hospital inpatient. You only become an inpatient after your doctor formally admits you the hospital.
Dr. Shiraz Yazdani, raised in Kentucky, received his Bachelor of Science degree in Psychology from the University of Kentucky in Lexington, Kentucky.
He is a graduate of The Ohio State University College of Medicine and completed his residency in
Anesthesiology and Internal Medicine at Texas Tech University Health Sciences Center in Lubbock, where he was Chief Resident in the Anesthesiology Department from 2012-2013. He completed his
Fellowship in Pain Medicine at The University of Texas MD Anderson Cancer Center in Houston, Texas.
Dr. Yazdani provides both comprehensive and conservative pain management care. Dr. Yazdani has extensive experience in the treatment of cancer pain. Through effective pain management, patients reduce their pain and return to more active and rewarding lifestyles. Dr. Yazdani also helps patients understand and manage their chronic pain. Included in the long list of services he provides are:
• Fluoroscopically and ultrasound guided injections and nerve blocks
• Radio frequency and chemical neurolytic procedures
• Implantable devices such as spinal cord/peripheral nerve stimulators and intrathecal pumps
• Botox injections and nerve blocks for headaches and facial pain
• Minimally invasive spinal procedures such as vertebroplasty and kyphoplasty
Dr. Yazdani’s philosophy centers on the complete treatment of each patient’s unique pain profile. He focuses his efforts on individualized care while concentrating on patient comfort, convenience, confidence, and peace of mind.
He is married and enjoys spending time with his wife, who is a graduate student at Texas Tech, traveling, running, and rooting for the Red Raiders.
Dr. Yazdani’s practice is located at PNS’s I-27 Medical Center, 4105 I-27, in Lubbock. To schedule an appointment with Dr. Yazdani, call his office at 806.762.2633 or contact your primary care provider for a referral. At I-27 Medical
Center, Medicare, Medicaid, Workers’ Compensation and most commercial insurances are accepted.
Seniors Are Special is a service of UMC Health System and Texas Tech University Health Sciences Center
602 Indiana Ave • Lubbock, TX 79415 • 806-775-8760

Effect of Tocotrienols (vitamin E isomers) on Bone Health
Who is Needed : Postmenopausal women (at least one year after menopause, age 40 and older)
When : Now for a 12-week study
Texas Tech University Health Sciences Center researchers are conducting a 12-week research study examining the effects of tocotrienol, a type of Vitamin E, on bone health.
This study requires participants to be randomly assigned to take tocotrienols or a placebo and includes a bone density scan and some blood tests, such as blood chemistry, vitamin D, and thyroid hormone, at no cost to participants.
Leslie Shen Ph. D professor of pathology, TTUHSC School of Medicine, leads the study; it is funded by a grant from the
American River Nutrition Inc.
For more information or to participate, contact Anna Rodriguez: 806-743-2533 or anna.rodriguez@ttuhsc.edu
Staying socially engaged helps ward off memory loss and dementia. So how do you refresh your social network? Try these nine ideas.
• Social Network: Social media sites, like Facebook, offer the chance to reconnect with old friends and reinforce ties to new ones. Terrified of technology? Check out Seniors are Special who will soon be offering computer courses through the City of Lubbock Parks & Recreations Department. SeniorNet also offers workshops on computer use and Internet safety over the internet.
• Volunteer: Any time you reach out to others, you boost brain health, too. UMC Volunteer opportunities are plentiful call Susan Bailey 775-8680 for information.
• Consider a Move: Many of us want to grow old in the same place we’ve always lived. However, for some, a move to
Lubbock or another part of the community — perhaps one with shops and restaurants, within easy walking distance.
Lubbock is a college town that offers a multitude of on campus options.
• Deep: You don’t have to be a social butterfly to reap the benefits of social engagement. A few close relationships are just fine. It’s not the number, but rather the richness and depth of relationships that counts.
• Get on the Road: Dozens of tour companies now cater to older adults including Seniors are Special and Road Scholar
(formerly Elderhostel). In addition, Texas Tech Alumni Association sponsors trips.
• Pursue Your Passion: When you do something that sparks your interest — cooking classes, a jewelry-making workshop — chances are you will meet someone who shares a similar curiosity. See him or her every week and a new friendship is born.
• Just Say Yes: If someone invites you for tea, lunch or the ballet, go — even if you don’t know an arabesque from an assemblé . The more you put yourself out there, the more people you’ll meet. It is not a lifetime commitment, just a fun outing.
• Think Local: Community activities give you a chance to meet a diverse group of people who live nearby. Check newspaper listings and drop by that gallery opening or book reading. If you attend and enjoy chatting with someone, jot down his email or phone number so you can stay in touch.
• Friends: When you are young, making friends seems effortless. However, the older you get, the more challenging it can become. And that can spell trouble, because a mountain of studies tells us that staying socially engaged stimulates the brain in areas critical to learning and memory.
Adapted from an article by Margery D.
Rosen, AARP, July 9, 2013

Hypertension or high blood pressure affects a large population of people in the United States, making them at risk of developing cardiovascular disease, heart failure, kidney failure and strokes. This risk increases with progressive elevations in blood pressure.
There is substantial evidence that multiple dietary factors affect blood pressure. It is important to stress the benefits of making dietary modifications, which could reduce the risk associated with elevated blood pressure. These modifications include weight loss, limiting salt intake, eating fruits and vegetables, and limiting alcohol use.
Several studies have been performed that support the idea that weight is directly associated with hypertension and that weight loss improves blood pressure. Daily exercise and a healthy diet can prevent weight gain and control blood pressure.
Diets low in sodium and rich in potassium prevent blood pressure rise.
Recent guidelines recommend that daily dietary intake of no more than 2,400 milligrams of sodium per day, primarily to ensure nutrient adequacy and control blood pressure. As dietary salt (sodium chloride) intake rises, blood pressure rises increasing the risk of complications.
Vegetarian diets have been associated with low blood pressure. Individuals who consume a vegetarian diet have markedly lower blood pressure readings than non-vegetarians. Our diet should include 8-10 servings of fruits and vegetables per day, be rich in low-fat dairy products and limited saturated fats. High dose omega-3 polyunsaturated fatty acid (commonly called fish oil) supplements can lower blood pressure in hypertensive population.
In summary, regular exercise and a healthy diet will help in controlling blood pressure and prevent complications associated with uncontrolled hypertension.
Dr. Kashif Saleem is a Family Practitioner with Internal Medicine
Associates of Lubbock located in the Medical Office Plaza at UMC. He is accepting new Medicare patients. He provides continuity of care for patients, treating them in both the practice setting as well as while they are in the hospital. For further information or an appointment, please call 806-762-8461.
The employees of UMC honored Dr. Saleem as UMC’s Attending Physician of
the Year for 2013.
OLLI’s Fall 2014 Kick-Off Event
Please join us for an evening of great food, meet several instructors, hear about upcoming classes, giveaways, and make new friends at Kick-Off for
Osher Lifelong Learning Institute (OLLI) Fall 2014 semester.
• Thursday August 21, 2014
• McKenzie-Merket Alumni Center
• 17th & University Ave, Lubbock
• 5:30 - 7pm
• $8 per person includes steak and potato buffet dinner
• Tickets must be purchased by Aug. 14th
To register, or for additional information call the OLLI office: 806-742-
6554
Front row: Lorrie Villarreal, Benefit
Specialist; Sabrina Pena, Receptionist
Back row: Loralee Van Wettering, Au.D.,
CCC-A; Renee Zimmerman, Au.D., CCC-A;
Amber Caldwell, B.S.; Anita Peckham, M.S.
Hearing loss and hearing related concerns may not be something that is noticed overnight.
Many times, a gradual onset and progression of hearing difficulty is the case. The Hearing and Balance
Center at UMC and “Seniors are
Special” understand the value and necessity of optimal hearing for communication, social interaction, and simply listening to sounds in your home.
The Hearing and Balance
Center at UMC would like to extend a 15% DISCOUNT on HEARING
AIDS to all UMC Seniors are
Special Members. This offer will apply to any single or pair of hearing aids you choose. If you are experiencing:
• Difficulty hearing other people’s voices
• Ringing in one or both ears
• Fullness or pressure in one or both ears
• Dizziness or balance problems
• Or your current hearing aid is not working well for you any longer.
To comply with new Medicare policies, your primary care physician will need to call the
Hearing and Balance Center at UMC at (806) 775-9305 to authorize a hearing evaluation or hearing aid consultation with one of our certified audiologists.
UMC’s Courtesy Shuttle vans provide free shuttle service between 2:30 PM and 3:30 PM and from 4:15 PM to 5:15 PM for our seminar guests. The shuttle picks up at the Texas Tech parking lot located WEST of the Texas Tech Parkway, off 10 th Street. Turn west at the 10 th Street & Texas Tech Parkway light. The parking lot is located one block down on your left hand side of the street.
Follow the SAS parking signs. You are, however, free to park in any of UMC’s parking lots.
UMC’s Better Breathers Club to meet at UMC Activities Center
The UMC Better Breathers Club is a support group for people with Chronic
Lung disease such as COPD, Asthma,
Pulmonary Fibrosis and Lung Cancer.
Joining is free! Learn to manage your lung disease and live better. The
Better Breathers Club meets the second
Monday of every month from 6:00pm to 7:30pm at the UMC Activities Center at 5217 82 nd Street, 82 nd & Slide in
Rockridge Plaza. Our next meeting will be August 11th. This month’s guest speaker is Jennifer Gutierrez, Speech
Pathologist with Physical Medicine and
Rehabilitation at UMC. Jennifer will be speaking on Dysphagia and COPD.
For additional information, contact
Lori Stroud at 775-8950.

Change: Does change make you angry? Do you resist it, blame others for it, ignore it, or just go with it? Often we experience more than one emotion or feeling. Our response to change may differ depending on the way things vary widely from a little hiccup to a life-altering event. Sometimes we are the ones initiating the change and other times the change is brought upon us. One thing that is certain, change is going to happen, whether we like it or not, it is just a matter of time.
It is important to remember that when we encounter a hiccup or a life altering event, that you can and will make it through to the other side. The first phase of change is the scariest, especially since we are not taught to expect it. At the time it might be hard to digest; you can do more than just go through the motions but revel in it. Think about a butterfly and the metamorphosis a caterpillar undergoes from a fat ugly worm to hardened cocoon to a beautiful winged butterfly. The only part of change you can control is you.
Take your time to be upset, vent, and complain, whatever you need to do, but set a cutoff time to these emotions or actions. Whether it is minutes, hours, a day, several days; have a deadline to accept the change gracefully. If we don’t give ourselves a time limit of being upset and try to act like everything is fine we run the risk of bottling up emotions that could explode and damage those around us.
Don’t think that you’re alone in this transformation. Whether the change you’re experiencing is at work, home, kids leaving the nest, divorce, physical changes or loss, there is someone else that has experienced the same thing. Talk to friends or family that have gone through a transformation to get the reassurance and encouragement you need to thrive through this process.
Develop a plan of action to assist with dealing with the situation, especially if it is unexpected. Figure out what you need to do to make this transformation work. It may take some time and trying different options to find what makes you comfortable with the change but it will come. Remember to be patient, breathe and trust the process. Your inner strength will surprise you.
Class Spotlight: The class under the spotlight this month is Pilates with Sheila . Pilates is a system of strengthening and stretching exercises designed to develop the body’s core, mobilize the spine and build flexibility. Increases range of motion in all joints and movements of the body. Pilates is a low to moderate class with both mat and standing activities.
The body’s core consists of the lower and upper abdominals, internal and external obliques, and the opposing muscles of the lower and middle back. Pilates offers functional strength in that it trains the body to uphold correct posture while performing the exercises. The movements engage often neglected muscles building equal strength in both the front and back of the body. This leads the body to be balanced in both strength and flexibility and for you to develop better overall control of your body.
What do increased strength, flexibility and control mean for you? The possibility of decreased injuries!
The increased awareness can help you pick up the box you need moved or assist when reaching into the cabinet getting a serving dish. One thing to remember: Pilates as with any exercise may cause a little muscle soreness a day or two later. You challenged your muscles in ways they may have not moved before so this soreness is normal. Come give Pilates a try! Pilates with Sheila meets on Tuesday and Thursday at 11:00AM.
From the Membership: We asked Activities Center member JoBeth to share with us her thoughts on
Pilates.
Excluding instructors, raise your hand if you can’t wait for the next exercise class. I thought so....most of you are on my page, exercise isn’t a choice it’s a must. The question I’m often asks is ‘what is Pilates’? Joseph Pilate answered it best
“you are only as young as your spine is flexible.” Several years ago two pesky discs decided they wanted a new view and took the plunge. Six weeks of Physical Therapy helped tremendously with my recovery but needed to continue some form of exercise. Pilates was my choice for maintenance because stretching and muscle tone is essential for good posture, which strengthens the core, so the spine will behave. I recommend this class for anyone because of the long-term benefits. The Pilates instructor is very informative keeping up to date with new forms of conditioning while working with individual levels. By the way men, this is not just a women only class the male gender needs core strengthening too.
Nutrition Talk at the UMC Activities Center: On Wednesday, August 20 th at 3:00PM, the UMC Activities Center will host its monthly Nutrition Talk with Autumn Bollinger, MS, RD, LD. The topic this month will be “Hydrating Right .
” Come learn tips to staying hydrated during the summer heat.
The lectures are open to anyone so feel free to invite a family member, friend, or neighbor to attend! The UMC Activities Center is located at 5217 82 nd Street (SW corner of 82 nd & Slide in the RockRidge Plaza). For further information, contact the office at 783-8829.
2014 Ice Cream Social and Sock Hop Dance: The UMC Activities Center will host its annual Ice Cream Social and Sock Hop
Dance on Friday, August 1 st , 6:30pm-9:00pm. Put on your favorite poodle skirt or rolled up t-shirt and come join the fun! (Costumes are not necessary to attend). This dance is open to anyone who wishes to attend; tickets are $5.00 per person in advance or $7.00 at the door. Refreshments will be served; however, feel free to bring your favorite treat to share. For further information, contact the office at 783.8829.
Matter of Balance: The UMC Activities Center will be hosting A Matter of Balance classes in August. This is a free program where participants will gain confidence and reduce their risk of falls. You should attend A Matter of Balance if you: are concerned about falls; are interested in improving balance, flexibility, and strength; have fallen in the past; or have restricted activities because of worry about falling. Preregistration for this class is required. Classes will be held Tuesdays and Thursdays, 1:30pm-3:30pm August
19 th – September 11 th . For more information or to pre-register you can contact Julie Dominguez at the UMC Activities Center at 783-
8829.
Closed for the Labor Day: The UMC Activities Center will be closed on Monday, September 1 st for Labor Day. Regular hours will resume on Tuesday, September 2 nd . Have a safe and happy holiday!
Everyone is welcome to this free medical seminar.
We will be serving refreshments
Join us for Seniors are Special’s monthly educational seminars. These seminars meet on the second Wednesday of each month beginning at 3:00 PM in UMC’s McInturff Conference Center. The meetings are free, open to the public, and no reservations are necessary. Please bring a friend. For further information on these meetings, call SAS at 806-775-8760.