WHAT ARE LONG-TERM ACUTE CARE HOSPITALS?
Within the continuum of healthcare, long-term acute care hospitals (also known as “LTACHs”) provide specialized acute care for medically complex patients who are critically ill; have multi-system complications and/or failures and require hospitalization, averaging a length of stay of 25 days or more, in a facility offering specialized treatment programs and aggressive clinical and therapeutic intervention on a 24-hour/7-day-a-week basis. Many of the patients are admitted directly from a short-stay hospital intensive care unit with respiratory or ventilator-dependent conditions or other complex medical conditions requiring aggressive and continuous acute care services. The first free-standing LTACHs under the current Medicare definition were established in the mid-1980s.
LTAC hospitals differ from chronic care settings in that the LTACH focus is on treating these critically ill and/or high acuity patients in an intensive way, utilizing specialized treatment programs geared to each patient’s illness and requirements. The goal is medical recovery and return to home and family. These programs and this focus are not generally available or appropriate in a chronic care facility.
LTAC hospitals differ from nursing home/subacute programs in that their patients are much more acutely ill, often critically ill, and require more specialized programs and intensive nursing intervention than are generally available within subacute programs.
The severity of the LTACH patient’s condition requires a hospital stay that provides:
• Interactive physician direction with daily on-site assessment;
• Significant ancillary services as dictated by complex, acute medical needs – such as full service and STAT laboratory, radiology, respiratory care services, etc;
• A patient-centered outcome-focused, interdisciplinary approach requiring a physician-directed professional team that includes intensive case management to move the patient efficiently through the continuum of care;
• Clinically competent care providers with advanced assessment and intervention skills;
• Education for the patient and family to manage their present and future healthcare needs. |
These hospitals focus on patients with medically complex conditions or multiple conditions (comorbidities). Many patients arrive directly from intensive care units of general hospitals, with patients often still on life support. Our aggressive clinical and therapeutic intervention involves daily physician monitoring, 24-hour RN care with a high proportion of licensed clinical staff, significant ancillary services and complicated medication regimens.
In October of 2002 the U.S. Department of Health and Human Services implemented a prospective payment system for LTACHs.
*The Acute Long Term Hospital Association (ALTHA) represents over 160 LTACHs (both free-standing and “hospitals-within-hospitals”) in 29 states nationwide, specializing in intensive care for long stay patients. Mr. Baronoff is on the board of directors and is an officer of the Acute Long-Term Hospital Association (ALTHA). For more information on ALTHA, visit www.altha.org.
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