Long-Term Care Hospitals’ Discharge Practices in the Spotlight

February 25, 2015 | Strategic Insights for Health System


Long-term care hospitals' discharge practices may be driven to maximize Medicare reimbursement policies, finds an analysis by the Wall Street Journal of nearly 860,000 paid claims for long-term care hospital stays from 2008 through 2013. The analysis, published February 17, 2015, found that long-term care hospitals discharged 25% of their patients during a three-day period after the patient's stay had reached a threshold that triggers the largest lump-sum payment from the Medicare program. During the three-day period, five times as many patients were discharged compared with the three-day period before the threshold is reached, the analysis found. The tendency to discharge during the three-day window after reaching the maximum reimbursement period was more prevalent in for-profit facilities, which discharged 27% of their patients during that time, compared with nonprofits, which discharged 16% of patients during that three-day window, the article said. Under Medicare rules, long-term care hospitals receive smaller payments for shorter stays until the patient's stay reaches a point when the lump-sum payment increases.

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