As a company that provides medical revenue cycle management, one of the healthcare specialties that we provide services for is long-term acute care hospitals or LTACHs. For readers who are not familiar with LTACHs (or LTACs) here is some brief background information.
The concept of long-term acute care hospitals was first introduced during the 1980s. By this decade, new technological advancements had been introduced to many intensive care units, which allowed many more patients to survive cases of acute illness or server trauma while in the ICU. However, these survivors were still considered chronically critically ill.
In fact, the term “chronic critical illness” started occurring in medical journals and literature in 1985. The briefest definition of this term is the medical condition of “damaged survivors of critical care” who will experience a prolonged recovery time that may occur over weeks or even months.
An LTACH (or LTCH) patient requires a level of care that combines the key elements of critical care, as well as the long-term goal of rehabilitation. This means that the demands for acute nursing and medical care can extend beyond the expected length of stay that is usually seen in a traditional hospital environment.
Long-term acute care hospitals specialize in the care of high-acuity patients who have become “chronically critically ill” and require medical treatment beyond the normal length of stay in a short-stay acute care hospital. This required level of care is beyond the normal scope of practice for inpatient rehabilitation or skilled nursing facilities (SNFs).
Officially, LTACHs are defined by the US Centers for Medicare and Medicaid Services as “acute care hospitals” with an average length of stay for a patient being 25 days or more. The Centers for Medicare and Medicaid Services also requires patients transitioning to LTACHs to have spent 3 or more days in an intensive care unit (ICU) immediately preceding their admission, or to have required mechanical ventilation for more than 96 hours.
LTACHs are either attached to an existing short-term acute care hospital or they exist as a free-standing facility. However, an LTACH is a fully functioning acute care hospital, not a skilled nursing facility or an inpatient rehabilitation facility. These facilities provide care for patients who have higher “acuity needs” than is typical for individuals in an inpatient rehabilitation facility or skilled nursing facility.
Within the post-acute care provider category, the goal of an LTACH is to provide the highest level of clinical expertise and require the greatest use of human and equipment resources in the provision of care to this fragile patient population.
In order to accomplish this goal, LTACHs often use a multidisciplinary approach to care, which includes physicians, nurses, respiratory therapists, physical therapists, pharmacists, dieticians, and case managers.
This interdisciplinary team approach continuously evaluates a patient’s progress and develops a plan for the next transition in care. This plan for transition is generated collaboratively with patients and their families while considering the available and/or required resources.
Patients may transfer to their home from an LTACH, while many others will transition to inpatient rehabilitation, skilled nursing, or hospice care. The decision to transfer to the next level of care is based on the patient’s medical stability and potential for rehabilitation, with the ultimate goal focusing on a patient’s “return to normalcy” and a “positive” patient outcome.
For more information visit: “Long-Term Acute Care: Where Does It Fit in the Health Care Continuum?”
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