The rehospitalization rate for skilled nursing residents is “alarming,” according to an expert’s report to the Medicare Payment Advisory Commission.

Between 2000 and 2004, skilled nursing facilities witnessed a 45% to 51% increase in resident rehospitalizations. There also was a 13% decline in the number of residents being discharged back to the community within 30 days, said Dr. Andrew Kramer, head of the Division of Health Care Policy and Research at the University of Colorado at Denver and Health Sciences Center.

The findings illustrate how certain incentives in the Medicare’s prospective payment system encourage facilities to dump the most complex patients and send them back to the hospital, according to Kramer. He presented his findings to MedPAC as part of his work on measuring quality for SNF short-stay patients.