The Department of Health and Human Services (HHS) Office of Inspector General (OIG) issued a report analyzing Medicare nursing home residents who experienced hospitalizations in fiscal year (FY) 2011. The OIG determined that nursing homes transferred one quarter of their Medicare residents to hospitals for inpatient admissions in FY 2011. Nursing homes transferred patients for a variety of conditions, most commonly for septicemia. In total, Medicare spent $14.3 billion on the nursing home hospitalizations. Based on these results, the OIG recommended that CMS establish a quality measure that describes nursing home resident hospitalization rates and report the measure on the Nursing Home Compare Website. In addition, the OIG advised CMS to direct state survey agencies to review rates of hospitalization for nursing home residents as part of the survey and certification process and guide agencies on how to interpret and use the quality measure.
The OIG report on nursing home resident hospitalization rates is available at:
Department of Health and Human Services Office of Inspector General. “Medicare Nursing Home Resident Hospitalization Rates Merit Additional Monitoring.” 19 Nov. 2013. OEI-06-11-00040. 19 Nov. 2013.