Q&A: Review of Cases Lasting Less Than Two Midnights

Q: What should the utilization review (UR) committee look for when an inpatient stay is less than two midnights?

A: If there are fewer than two midnights of care after the inpatient order is written (i.e., less than a 2-midnight stay), the UR reviewer should determine if one of the following situations applies to the patient’s stay:

An inpatient-only procedure

• One or more medically necessary midnights of outpatient care resulting in at least a 2-midnight stay
• One or more medically necessary midnights of care at another hospital prior to transfer resulting in at least a 2-midnight stay
• Unforeseen death, transfer, departure against medical advice, or election of hospice
• Unexpected improvement

For more information, see the Patient Status Training Toolkit for Utilization Review.

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