LTAC (long-term acute care) is the type of care provided in Kindred Transitional Care Hospitals. More than 20 years ago, Kindred helped to pioneer the long-term acute model of care. Today, Kindred has a nationwide network of transitional care hospitals unique in their ability to care for medically complex patients who benefit from extended recovery time.
LTAC patients receive this care through treatment delivered according to their individual needs. The majority of our patients are admitted after a stay in a short-term hospital, often from intensive care and step-down units. Kindred Hospitals specialize in caring for patients with:
Transitional care hospitals (certified as long-term acute care hospitals) are unique in their ability to care for difficult to treat, chronically critically ill patients who require specialized and aggressive goal-directed care over an extended recovery period. Typical patients have multiple co-morbidities, multi organ system failure, and significant loss of independence, most following a traditional hospital stay.
Transitional care hospitals are licensed as acute care hospitals with additional Medicare certification that supports a length of stay measured in weeks (more than 25 days on average for Medicare patients) as compared to the typical five day stay for patients in traditional hospitals. We are consequently unique in our ability to care for critically ill patients who require specialized, aggressive, goal-directed care over an extended recovery period. Transitional care hospitals provide long-term acute care (LTAC) to complex medically complex patients who require an extended stay in a hospital setting.
Transitional care hospitals are different from acute care general hospitals in that they treat patients who stay, on average, about 25 days. Care levels extend from ICU beds (at most of our hospitals) to monitored beds to general medical care. Most of our hospitals have ORs or treatment rooms for invasive and minor surgical procedures such as G-tube placement and wound debridement.
Nationally we have two types of transitional care hospitals. The first is a freestanding hospital, which typically has 50-80 patient beds. The second is an HIH, or hospital in a hospital. This is a Transitional Care Hospital located inside or on the same campus as a general acute care hospital. These tend to range from 30-45 beds. Both operate as independently licensed, certified and accredited hospitals.
The LTAC (long-term acute care) provided at Kindred Transitional Care Hospitals is unique for many reasons, including:
Our specialized services and extended care are tailored to medically complex patients who are unable to recover completely in a short-term setting.
We use patient screening criteria to evaluate the appropriateness of patients admitted to our hospitals to ensure that we are treating those medically-complex patients that benefit most from this level of care – and that patients requiring less-intense services receive care and rehabilitation in appropriate alternative settings.
The typical LTAC patient in our transitional care hospitals is older with three to six concurrent active
diagnoses, or someone who has suffered an acute episode on top of several
chronic illnesses. Over 95% of our patients are admitted from a STAC
(short-term acute care) hospital. Approximately 25% of our patients are on mechanical
ventilation, 25% have at least one wound, and almost 50% have a central line.
Approximately 40% of our patients are, on admission, colonized with MRSA, VRE,
resistant gram-negative organisms or C. difficile.
Most of our patients have already undergone extensive work-ups at the STAC and
have developed and initiated a treatment plan with the referring physician
team. Common conditions include but are not limited to ventilator weaning,
severe infection, complex wound care, CHF, COPD and renal insufficiency. As
many as 10% of our patients may require acute hemodialysis at some time during
their stay at our transitional care hospital.
Unlike STACs, transitional care hospitals are designed instead for the development,
administration and adjustments of prolonged medical treatment plans carried out
by a multidisciplinary team including nurses, respiratory therapists,
pharmacists, rehabilitation therapists and specialty physicians such as
cardiologists, neurologists, gastroenterologists and ENT physicians. The main
attending physician is generally a hospitalist, internist or pulmonologist.
In addition, due to the size of our hospitals, the Chief Executive Officer,
Chief Clinical Officers and Quality Managers are actively involved in the daily
care of patients.
Medicare patients are paid under a modified DRG system. About 50% of the
patients receive a DRG payment. Non-Medicare patients are paid by a contracted
or negotiated rate between the transitional care hospital and the insurer.
As with traditional inpatient care, prudent use of tests, prevention of
complications, and attention to patient safety are essential. We encourage and
promote the Medical Staff involvement in the hospital care teams such as
Quality Committee, Medical Executive Committee, Infection Control and
Transitional care hospital reimbursement for Medicare patients (70%) follows the usual Medicare
in-patient Evaluation and Management (E&M) fee schedule. Therefore,
reimbursement for a given E&M code is the same as if that care was provided
in a short-term acute care hospital. For managed care patients (15-25%), fees
are set by each insurance company, and vary between the in- network and
out-of-network fee schedule. Therefore, it is not necessary to be on a panel to
receive reimbursement. A few states have Medicaid rates for transitional care hospitals, and those
transitional care hospitals accept Medicaid patients. Physicians are paid according to that state’s fee schedule.
There are several types of physician opportunities available at Kindred.
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