This report explores factors that appear to drive relatively high rates of hospitalizations, based on interviews with doctors, nursing home staff and families in four cities.  Key factors include liability concerns, limited onsite staff capabilities, difficulty reaching residents' physicians for care instructions on nights and weekends, better and more timely access to diagnostic tests in hospitals, and patient preferences. Physicians with patients in a long-term care facility say it is more convenient and potentially in their financial interest to see patients in the hospital, based on their understanding of coverage and payment policy.

The report, co-authored by researchers at Lake Research Partners and the Kaiser Family Foundation, was released at an Oct. 12, 2010 policy briefing.

Report (.pdf)