Author: silverbergadmin

Many of you know I am a Kansas City Barbeque Society Certified Barbeque Judge. Over the years, I have judged numerous competitions up and down the East Coast. A number of years ago I joined the Barbeque Brethren, a group of competition barbeque teams on Long Island. Pre-covid, we hosted a BBQ for 1500 veterans and family members at the VA on Long Island for more than ten years. In 2016, the Barbeque Brethren learned nothing was being done to commemorate 9/11 for the 2,000 Navy, Coast Guard and Marines based at the Brooklyn cruise port.

(C) Stephen J. Silverberg 2016

A few strings were pulled by the Barbeque Brethren, who had been doing BBQ lunches for 1500 veterans and family members at the VA on Long Island for more than ten years.

The only ones permitted to attend this event was the crew, some of the VA home residents and members of the Barbeque Brethren. It was not open to the public.

While I was there, cooking and serving along with my fellow Barbeque Brethren, I saw the Coast Guard cruiser coming into port in front of the Freedom Tower and took this photo. Notice the ship’s number: 911.

The Coast Cruiser made its way past the Freedom Tower. It was a remarkable sight.

We shall never forget all those who were killed on the day of the attacks and who have died as a result of their efforts afterwards.

The Medicare Observation Trap happens when patients and families are least expecting it. The patient has a serious health emergency and goes by ambulance to a local hospital. Family members are worried, and the patient might not know what is happening around them. The patient goes to the Emergency Room, where they undergo a thorough evaluation, and doctors decide whether the patient needs to remain in the hospital or can go home.

If you decide to remain in the hospital, the Medicare Observation Trap can limit the care you receive when discharged.

Most Medicare patients rely on Medicare for their hospital coverage and, when needed, up to 100 days in a rehabilitation facility. But what often happens when a patient remains in the hospital for observation without being admitted? The patient might be ineligible for Medicare coverage of rehab.

Hospitals often register elderly patients as under observation rather than admitting them as patients. Observation can last days or weeks – with the same level of treatment as an admitted patient.

Why would the hospital do this? Hospital billing departments often make this decision, not the doctor. The billing department is concerned about getting paid. Medicare reimbursement might not happen if a Medicare auditor overturns the physician’s decision to admit the patient. The observation payment rate is lower and is less likely to be denied—the hospital bills Medicare Part B rather than Part A.

Part A of Medicare coverage only begins upon admission to the hospital. Patients “under observation” are technically outpatients, no matter how long they are in the hospital.

This practice impacts care after hospitalization when the trap is sprung. If you are in the hospital on “observation” status, no matter how long you are in the hospital, Medicare will not pay for skilled nursing care in a rehab center. The patient or the family may realize none of this – until a massive bill arrives.

How can you protect yourself or a loved one from the Medicare Observation Trap?

Be clear with your doctors as to the patient’s status. Even if they say they are waiting for a bed to become available, insist that the patient be formally admitted and firmly ask for a document showing the patient’s admission.

If the patient needs to go to a skilled nursing center immediately after hospitalization, make sure you bring the admission document with you. Let the nursing center’s office keep a copy of the document – you must keep the original.

It is an important detail you must remember during a medical emergency,  as it could protect the patient or their family from a financial emergency.

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Sky-high prices for beef make this the year to expand your grilling horizons, with less expensive cuts of meat, new takes on chicken and adding more than salmon to your fish repertoire. Here are a few ideas to try out:

Try beef brisket instead of more traditional sirloin steaks. Prepare the brisket for low and slow cooking with a marinade – the recipe below is a traditional BBQ marinade – or swap out cayenne pepper for cardamom and turmeric for a completely different take on brisket.

• ½ cup Kosher Salt
• 3 TBS Black Pepper
• 2 TSP Cayenne Pepper
• 2 TSP Brown Sugar
• ¼ cup Apple Cider Vinegar
• One Clove Garlic, finely chopped.

Start early in the day, as brisket can take five to eight hours to reach an internal temperature of  185-190 degrees.

Some folks like to sear their brisket, 20 minutes per side on a hot grill – 400 degrees –  then switch to low and slow at 250 degrees. Check the brisket temperature every hour.

What other fish can you grill besides salmon?

Any fish with thick flesh works great on the grill as long as you prepare the grill and the fish right.

What kind of fish? Tuna, red snapper, sea bass, grouper and halibut are all good for grilling.

Prep the grill by using a grill marinade brush dipped in vegetable oil and rub it over the grates. Keep going until the grate is glossy and black, seasoned like a cast-iron skillet.

Coat both sides of the fish with a layer of vegetable oil with a brush.

Place the fish on the grill, diagonal to the grate slats, skin side down. Lower the heat to medium.

Cook for 2 – 4 minutes or until the skin is crispy.  Use two spatulas for more control, and if it doesn’t come off cleanly, keep cooking it another minute until it does.  Flip the fish and keep cooking for another 3 – 7 minutes.

If you’re cooking salmon, the center should be opaque and reach 125 degrees. Any fish with white flesh should be cooked until the internal temperature reaches 140 degrees.

Grill baskets are a great idea for fish, especially if you’re grilling a whole fish. Be sure to use vegetable oil on the basket so the fish doesn’t stick to the basket.

What’s this I’m hearing about braided salmon bread that looks like challah?

I haven’t tried this, but it’s on my list for this summer. You’ll need a big fillet, skinned. Brine it, then cut into four equal long strips. Braid it as if you were making challah bread, then season with a salt-free rub (the brine will provide the salty flavor). Use a simple glaze, citrus and maple syrup will do. Cook it low and slow on the grill – depending on the density of your challah, about an hour or until the internal temperature is 125-130 degrees.