Pennsylvania Nurse, Front Page 69(4) - Page 17

Two-Midnight Rule In October 2013, the twomidnight rule (CMS-1599) was put into effect. Observation care is defined by CMS as a welldefined set of specific, clinically appropriate services. These services include ongoing shortterm treatment and assessment/ reassessment provided while a decision is being made whether patients require further treatment as inpatients or if they are able to be discharged (Centers for Medicare & Medicaid Services, 2014). The two-midnight rule further defines inpatient versus observation status by a defined amount of time. Per 5L