Within 24 hours after a patient’s placement into observation status by a hospital, the hospital shall provide that patient with an oral and written notice that the patient is not admitted to the hospital and is under observation status. The written notice shall be signed by the patient or the patient’s legal representative to acknowledge receipt of the written notice and shall include, but not be limited to, the following information:
         (1) a statement that observation status may affect
    
coverage under the federal Medicare program, the medical assistance program under Article V of the Illinois Public Aid Code, or the patient’s insurance policy for the current hospital services, including medications and other pharmaceutical supplies, as well as coverage for any subsequent discharge to a skilled nursing facility or for home and community based care; and
        (2) a statement that the patient should contact his
    
or her insurance provider to better understand the implications of being placed into observation status.

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