In today’s health care system, severely ill seniors are admitted to acute care hospitals for inpatient services for a relatively short stay. Long-Term Acute Care hospitals (LTACHs) fill the niche for those who require a longer hospital stay.
The New Jersey-based Specialty Hospital of Central New Jersey is one of 400 LTACHs in the United States, and the number of patients in such facilities has more than tripled in the past decade—reaching 380,000 patients, according to one estimate.
Specialty Hospital of Central New Jersey along with LTACHs throughout the nation play an important role in providing health care to acutely patients who are critically ill and have one or more serious medical conditions which require lengthy hospitalization. Most patients, receiving services like respiratory therapy, wound care, head trauma treatment, and pain management, stay on average for more than 25 days.
Medicare Payment Rules
According to the Center for Medicare and Medicaid Services (CMS), you generally do not pay more for services provided in a LTACH than in an acute-care hospital. Under Medicare, you’re only responsible for one deductible for any benefit period, beginning the day you’re admitted to an acute care facility or skilled nursing facility (SNF), and then ends when you haven’t gotten any inpatient care in a hospital or SNF for 60 days in a row. This applies whether you’re in an acute care hospital or a LTACH.
CMS says that you don’t have to pay a second deductible for your care in a LTCH if: you’re transferred to a LTACH directly from an acute‑care hospital. Or you’re admitted to a LTACH within 60 days of being discharged from an inpatient hospital stay.
CMS adds, if you’re admitted directly to the LTACH more than 60 days after any previous hospital stay, you would pay the same deductibles and coinsurance as you would if you were being admitted to an acute‑care hospital.
For more details about services provided in LTACHs and Medicare coverage, go to Medicare.gov, or call 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048.