Community Hospital Corporation (CHC) understands the challenges that long term acute care hospitals (LTACH) face in balancing the bottom line with a strong commitment to quality patient care. Keeping up with the ever-changing requirements and reimbursement regulations of the Center for Medicare and Medicaid Services (CMS) introduces additional complexity.

Since 2004, CHC has helped LTACHs improve clinical outcomes while boosting financial performance. Our experience led us to develop these factors critical to LTACH success.

During the COVID-19 pandemic, the vital role of LTACHs in the continuum of care became more evident. LTACHs served as a relief valve to handle patient overflow from traditional Short Term Acute Care Hospitals.

Roadmap for LTACH Success

• Patients in an LTACH often need extended recovery periods to achieve optimal outcomes. Conversely, a general acute care hospital’s goal is to resolve the immediate health issue and discharge the patient as quickly as possible. Because of these fundamental differences between acute and long term acute care, the LTACH Chief Executive Officer must be deeply familiar with the LTACH environment.
• The LTACH must forge a strong relationship with its host hospital. Success depends upon a shared vision and alignment of clinical and financial goals between the institutions. Since the LTACH relies on—and pays for—many hospital services from its host organization, it is important to implement efficient, shared processes across both institutions.
• The LTACH management team must have intimate knowledge of regulatory requirements, especially since Medicare is a key payor for LTACH patient care.
• LTACH case managers, coders and the clinical staff must ensure accurate DRG coding. This process requires appropriate clinical documentation by the medical staff and concurrent review most importantly upon admission, throughout the stay and upon discharge. In a short term acute care environment, a specific diagnosis might be associated with a five-day average stay, but the same diagnosis might be associated with a 35-day stay at an LTACH. Thus, coding accuracy is crucial for compliance as well as reimbursement.
• LTACHs aren’t just about the 25-day length of stay. CMS periodically changes LTACH regulations. It is critical that LTACH executive leaders remain current about any changes in the length of stay calculation, Medicare Conditions of Participation, LTACH criteria and payment rules, and other requirements.
• The LTACH operates most effectively with a staff that includes a complement of medical specialties. All clinical team members must work together to ensure patient needs are met within a long term acute care environment. It is key to establish ongoing education for physicians, general acute care hospital staff and LTACH staff regarding the changing parameters of the LTACH environment. This practice encourages the entire care team to collaborate in improving clinical outcomes.
• The LTACH must ensure a steady volume of admissions from multiple sources. If managed efficiently, long term acute care hospitals provide a financially strong healthcare environment for critically, chronically ill patients and operational benefits for host hospitals, including the following:
  • Enabling better outcomes for critically, chronically ill and medically fragile patients
  • Allowing a healthy patient flow in and out of the host hospital’s ICU and other Critical Care Units
  • Providing a new revenue stream for the host hospital in a scenario in which the LTACH pays for services such as rent, dietary, radiology, housekeeping, information technology and other services

CHC ContinueCARE brings experience and blue-sky thinking to LTACHs across the country.

About Community Hospital Corporation

Community Hospital Corporation owns, manages and consults with hospitals through CHC Hospitals, CHC Consulting and CHC ContinueCARE, with the purpose to collaborate with partners and bring innovative solutions to support the vibrancy and accessibility of community healthcare. Based in Plano, Texas, CHC provides the resources and experience community hospitals need to improve quality outcomes, patient satisfaction and financial performance.

Download PDF file of Prescription for LTACH Success