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.

ROADMAP FOR LTACH SUCCESS

The LTACH must forge a strong relationship with its host hospital. Success depends upon a shared vision and alignment of clinical 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. This is especially important since Medicare is a key payor for LTACH patient care.

“Beyond LTACH operational success, our experts keep informed about the ever-changing requirements and reimbursement regulations of the Centers for Medicare and Medicaid Services (CMS), and advocate for LTACHs at the local and federal level.”

APRIL MYERS CHC SVP, Post-Acute Operations

Board Member, National Association of Long Term Hospitals (NALTH)

 

Success depends upon a shared vision and alignment of clinical and financial goals between the LTACH and its host hospital.

• 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 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 an average 25-day stay at an LTACH. Thus, coding accuracy is crucial for compliance as well as reimbursement.
• LTACH patients often require extended hospitalization of 25 days or more. CMS periodically changes LTACH regulations. Thus, 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 and improve clinical outcomes.
• The LTACH must ensure a steady volume from a broad market area. 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 safe and efficient 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 and other services

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

Download PDF file of Prescription for LTACH Success