This study provided information on long term care hospitals (LTCH) short-stay outliers. Short-stay outliers are LTCH stays ending before reaching five-sixths of the average length-of-stay for the patient’s diagnosis under the long term care diagnostic related grouping (LTC-DRG) category.
Short-stay outliers decreased from 40 percent of LTCH stays discharged in 2003 to 27 percent of stays discharged in 2006. Some patients may have been inappropriately placed in LTCHs or discharged based on financial incentives. From 2003 through 2006, LTCHs (1) discharged over a third of short-stay outlier patients at least 10 days before patients reached the short-stay outlier threshold, (2) greater proportions of patients were also discharged within 2 days of having qualified for full LTC-DRG payment, and (3) LTCHs discharged short-stay outlier patients to acute care facilities more frequently than other LTCH patients. For 2005 and 2006, short-stay outlier payment errors mirror those of other LTCH claims. Most payment errors Quality Improvement Organizations identified with LTCH claims were inaccurate LTC-DRGs and inappropriate LTCH admissions.
Report Title: Long Term Care Hospitals Short-Stay Outliers http://oig.hhs.gov/oei/reports/oei-01-07-00290.pdf
Agency Sponsor: OS-OIG, Office of Inspector General
Federal Contact: Erin Lemire, 202-205-9523
Performer: Staff; Office of Inspector General
PIC ID: 8978