In the US, there are over 1 million hospitalizations for heart failure annually (1–3). This number appears to be increasing each year and equally affecting men and women. Rehospitalization following heart failure admissions remains high, with recent reports from the Centers for Medicaid and Medicare Services suggesting that hospitalization rates may approach 25% at 30 days, and this may exceed 50% in some health systems (4–8). In addition, recurrent hospitalization following heart failure admission and myocardial infarction admission have become indicators of quality outcomes (9). Report cards for hospitals in the US that care for Medicare patients have been publicly reported and highlighted in the media and public Websites. Some of the top 10 heart centers in the US had low 30-day mortality rates, but higher than average rehospitalization rates (7). This raises the question as to whether rehospitalization following a heart failure admission is an appropriate indicator of quality for the health system.