The saddest holding I've seen in my career was an inpatient mental health ward that had patients huddled up sleeping on the floor in the hallways overnight with 1 tiny blanket each.

It's generally a cost generating maneuver and diversion tactic to stall medicare-only (unprofitable patients) so they leave without getting assigned a room. Leaving without being seen (LWBS) is tracked as a quality metric by the government, so if the hospital sees them, makes a care plan, stalls them in the hallway for 10 hours and the patient gets frustrated and leaves themelves it's "elopement" not LWBS so the hospital doesn't have to spend money to care for the no-insurance unprofitable patient but also doesn't get dinged on their medicare quality metrics.

The other problem is elderly who have no places to go for discharge. No family support, no insurance for a SNF, no suitable housing or money for a board and care. These patients can stall waiting in the ER for 100 hours or more while a care worker is assigned and tries to sort out where they can go.