Medicare Nursing Home Resident Hospitalization Rates Merit Additional Monitoring

November 1, 2013
The federal Department of Health and Human Services, Office of the Inspector General (OIG) reviewed Medicare administrative and billing data for nursing homes and hospitals to identify all Medicare residents in Medicare- or Medicaid-certified nursing homes who were transferred to hospitals for inpatient stays in fiscal year 2011. The OIG sought to calculate the percentage of Medicare nursing home residents that each nursing home hospitalized. The OIG identified diagnoses associated with the hospitalizations, calculated Medicare reimbursements for hospital stays, calculated the rates and costs of hospitalizations of nursing home residents, and examined the extent to which . . .