California Bill to Step up Safety for Patients in Hospital ‘Observation’ Settings Advances

[herring_RN, ASN, BSN]

Use of ‘observation' status is an escalating abuse that puts patients at health and financial risk, nurses say. The bill would extend protections for observation” patients that are provided to other patients in the hospital setting...

... In part, the goal is to avoid federal penalties for patients who are frequently re-admitted to hospital care after discharge; the same penalties do not apply for a patient re-admitted after discharge from an observation unit. Observation status is treated as outpatient, not inpatient care, and is billed by hospitals on an hourly basis rather than on an inpatient daily rate – an economic incentive for hospitals to warehouse patients in observation status to increase their profits...

... SB 1076:

* Clarifies that observation units must meet the same staffing standards as emergency rooms.

* Builds on the federal NOTICE Act by requiring hospitals to provide notice to patients that observation services are outpatient” services and third-party reimbursement may be impacted.

* Requires, if a hospital provides observation services in a dedicated unit that is neither the emergency room nor part of the normal inpatient beds, that this unit be marked with signage identifying the area as an outpatient area.

* Requires hospitals to report observation services to the Office of Statewide Health Planning and Development.

* Prohibits hospitals from evading the requirements by disguising observation” units with a different name...

RNs Welcome Bill to Step Up Public Safety for Patients in Hospital ‘Observation' : Indybay

[herring_RN, ASN, BSN]

In California ER staffing is four or fewer patients per nurse:

View Document - California Code of Regulations

Text of SB 1076:

SB 1076 Senate Bill - INTRODUCED

[whichone'spink, BSN, RN]

I work in another state, and our observation unit has a mix of inpatients as well. In fact, oftentimes, observation patients stay more than 24 hours, and still stay observation status. If you or your loved one are ever admitted to the hospital, ask the doctor what their status will be. If it's not inpatient, then leave and take your chances at home. If you have chest pain, and the doctor wants to admit you for observation, you can easily leave and have an outpatient stress test scheduled on your own time. It's not worth it to be admitted for observation because you will end up paying the big bill that will come afterwards.