Long-Term Acute Care Hospitals (LTACHs) are specialty care hospitals designed for extended stay patients with chronic conditions. Patients are admitted to LTACHs following treatment in a traditional acute care hospital, but they no longer require intensive diagnostic procedures.
The care provided is more individualized and resource-intensive than is provided in a skilled nursing facility or nursing home.
LTACHs operate as freestanding facilities or as a “hospital within a hospital," with each type of facility operating under a different set of regulations. The average length of stay for LTACH patients is 30 days. Under Medicare guidelines, patients admitted to LTACHs must be in need of hospitalization for greater than 25 days and typically have multiple or complex medical complications.
Long-Term Acute Care Hospitals (LTACHs) have been around for nearly 20 years, but they may soon become extinct in American health care. First created to fill a vacuum in the continuum of care between the short-term acute care hospital and other post-acute care venues, LTACHs have provided a much-needed supplement to patient care, particularly the medically complex, long-stay patients that the venue was legislatively intended to serve.
Now, after several years of chipping away at LTACHs by the Centers for Medicare and Medicaid Services (CMS), Congress has imposed a 3-year moratorium on new LTACHs and additional LTACH beds.
A hospital-within-hospital LTAC must be:
- Separately owned and licensed
- Must maintain a separate board and administrative structure and must have a separate medical staff
- The hospital must operate for a minimum of six months under acute care PPS to establish its average length of stay at greater than 25 days before it can be certified by CMS as a long term acute care hospital for Medicare payment.
Here we go again...another one of Ray's misguided attempts to salvage the dying DRMC. The "hospital within a hospital" description should tell you all you need to know about the fiscal "organization" of an LTACH.
Here's how it works... Hospital official to patient: "Well, Mr. Jones, you are not sick enough for us to keep you in our hospital any longer (CMS won't pay us anymore), but we are going to transfer you to our LTACH, (three blocks away), so that you can continue to benefit from our specialized treatments." (Rehabilitation for which we can get paid by CMS). "Admission to our LTACH will greatly enhance your recovery."... (and our reimbursement as long as you don't die within 25 days of admission).
Get the picture? A properly run LTACH can be a valid alternative to home health or a nursing home, but given DRMC's history, you can bet the only one that will benefit from this new "medical service" is L. Ray Humphreys!