Observation stays exceed CMS guidelines

Observation care stays at hospitals for patients are often going beyond the 24-hour limit recommended by the Centers for Medicare & Medicaid Services, reported CNN Money.

About half of observation care stays were exceeding a full day, while nearly 15 percent were for more than 48 hours, according to the article, which cited a June study on observation care by researchers at Brown University and published in Health Affairs.

CMS guidelines state 48-hour-plus observation care stays should only occur in "rare and exceptional cases."

The use of observation care has swelled at hospitals in recent years, with some critics saying it is a way for hospitals to avoid penalties for readmissions. However, the practice also has come under fire because it shifts some costs over to patients because Medicare won't cover specific treatments without an inpatient admission.

For instance, Laraine Sickels underwent a five-day observation care stay at Providence Regional Medical Center in Washington state for a broken pelvis, according to CNN Money, and later transferred to a skilled nursing facility. However, without being admitted to the hospital, she had to foot a $7,000-plus bill from that facility.

"I'm frustrated and angry. The situation is ludicrous," Sickels told CNN Money.

To learn more:
- read the CNN Money article
- here's the Health Affairs study
- check out the CMS guidelines (.pdf)