The findings of the OIG report speak to the increasing medical complexity of patients receiving post-acute care in our nation’s nursing and rehabilitation facilities. A key driver of this increase in medical complexity is that these facilities are now the dominant provider of post-hospitalization services in the Medicare program. Take, for example, the findings of the 2009 Annual Quality Report:
- In 2006, hospitals discharged approximately 4 million Medicare cases to post-acute settings, of which over 50 percent went to nursing and rehabilitation facilities.
- From 2000 to 2006, there has been a 15 percent increase in the share of Medicare patients admitted to nursing and rehabilitation facilities. These post-hospitalization patients have a wide range of medical and rehabilitation needs.
- The percent of nursing facility patients receiving rehabilitative care increased from 77 percent in 2003 to 81 percent in 2005 and to 87 percent in 2007.
Because the patient population consists of more medically complex patients, their care is placed in a higher RUG designation. Moving forward into 2011, AHCA/NCAL will continue to work cooperatively with providers, lawmakers and the regulatory community to ensure that positive trends, like increasing the number of patients that return home, continue to advance.