Clostridium difficile is a major cause of healthcare associated infection, morbidity and mortality - especially in the elderly - resulting in high readmission rates and posing a huge burden to rising healthcare costs. Due to its potentially preventable nature, the Centers for Medicare & Medicaid Services (CMS) implemented rules in the Hospital Value Based Purchasing Program to penalize hospitals with high CD infection (CDI) rates. This study used a large nationally representative Medicare Advantage population to profile demographic traits and analyze trends in readmissions, mortality, emergency room visits and observation room stays in patients discharged with CDI from 2008 to 2011.