Responding to changes in the Medicare auditing system, which gave a bonus payment to audit teams that found questionable admissions, hospitals started holding patients in "observation" status even though the patients thought they had been admitted.
It leaves patients owing a lot more for their hospital stay, and -- worst case -- the entire nursing home bill if they are transferred to one. A number of Medicare patients and consumer groups are suing to get the problem solved, but so far it hasn't been.
Ina Jaffe of NPR explains more about the problem, and Kaiser Health News offers questions and answers.