Hospital Report Cards for Hospital-Acquired Pressure Ulcers: How does hospital performance by claims data compare to performance by standardized surveillance exams for hospital-acquired pressure ulcer rates?

Background: Since March 2011, hospital rates of hospital-acquired complications (e.g., pressure ulcers) from administrative discharge data (i.e., claims data) are publicly reported online. In 2015, these claimsdata generated complication rates will be used by Medicare to identify the top quartile of poor performing hospitals, to penalize by 1% less pay for all admissions. Concern exists regarding the accuracy and validity of complication rates as reported in claims data to compare hospitals. We evaluated whether hospitals in the top quartile of poor performance for hospital-acquired pressure ulcer (HAPU) rates according to claims data would be scored similarly when compared by HAPU rates from quarterly hospital-wide patient surveillance exams.