AARP Report: Increased "Under Observation" Patient Status Raises Questions

November 18, 2013

A new report shows a dramatic shift in the status of some hospital patients. The AARP report says many more patients are being listed as "under observation" than in the past, and leading to higher costs, and raising questions about quality of care especially for older patients.

Mary Jo George of AARP says for some services, Medicare requires a patient to be admitted, not under observation.

"If you do not have a three-day hospital stay, what happens is, the Medicare coverage will not cover your skilled nursing care,” George said. “So, it is pushed onto the senior, who will have to often pay large out-of-pocket costs."

The report says the use of observation status more than doubled in hospitals between 2001 and 2009, as did the length of time spent in observation, with visits longer than 48 hours increasing the most.