Long-Term Care Survey Alert

The 2011 OIG work plan addresses this issue.

Case in point: The 2011 OIG work plan says the OIG "will review the extent of hospitalizations of Medicare beneficiaries residing in nursing homes," noting that hospitalizations are costly and may signal quality of care issues, says Chicago attorney Neville Bilimoria.

The work plan also says the OIG will examine how CMS is overseeing nursing facilities whose residents show high rates of hospitalization, cautions attorney Paula Sanders, in Harrisburg, Pa.

In addition: The healthcare reform bill includes several billion dollars in savings tied "to fixing rehospitalization," observes Charles Root, PhD, a reimbursement and compliance consultant in Barrington, Ill. He thus predicts the government will "pay more attention to the flow of patients between different providers," and will either focus on preventing rehospitalization -- or look at how people "transition between the hospital and SNFs and even hospice.

"The basic motivation will be to save money," Root continues. "And the OIG will recognize that as an important place to look at, hoping they can find some sort of abuse to tack onto it."