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The letter by Langer et al provides additional data from the Wisconsin Veterans Home about the impact of the prospective payment system (PPS) on nursing homes in our state. Average hospital length of stay for their residents in 1986 was 6·35 days, which is significantly shorter than the 8·0 days we reported for Wisconsin's institutionalized Medicaid population in 1984. If these length-of-stay data are confirmed by other nursing homes, then the average length of hospital stays for nursing home residents has continued to decline since 1984 and is now significantly shorter than the 7·9 days reported by the Wisconsin Hospital Association for all Medicare beneficiaries in 1986.Although Langer et al do not provide pre-PPS data for comparison, their findings are consistent with the results of our study. The short hospital stays, the readmission rate, and the number of residents dying within 15 days of a hospital discharge
Sager MA, Leventhal EA. The Impact of Medicare's Prospective Payment System on Wisconsin Nursing Homes-Reply. JAMA. 1987;258(5):612. doi:10.1001/jama.1987.03400050053020