A 2018 survey from the Washington Hospital Association found 11 hospitals in the greater Puget Sound area had 1,441 patients who stayed 67 days, on average, beyond what was medically necessary. The problem is due to a number of factors, including a growing state population, increased demand and a shortage of direct care staff.
The arrangement harms hospitals as well as patients. Hospitals have a limited number of patient beds, and they are not reimbursed for caring for patients with no medical hospitalization need. The patients, meanwhile, often suffer psychological damage due to hospitals’ stressful environment.
Most of the patients are on Medicaid, Medicare or both. They are generally either patients who come to the hospital with acute care needs but stay after they are ready to be discharged, or patients admitted to the hospital with no medical need. The latter are called “social admits”: They have no acute medical condition but are too unstable to turn away, and they have no one to care for them.
The Washington State Hospital Association, the state’s developmental disabilities ombudsman and some state lawmakers have called for changes to improve the system, but significant reforms could take years.
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