The California Nurses Association is backing another legislative attempt to tackle the controversial issue of hospital "observation" stays. A similar bill died in committee last year. Senate Bill 483 by Jim Beall, D-San Jose, seeks notification requirements and restrictions on observation stays in acute-care hospitals. These short stays typically start in the emergency room and may involve what looks like hospital admission, but are ultimately considered outpatient care by the Medicare program. This means patients pick up a bigger share of the tab — and many have no idea this will happen.