LTCH Facilities Give Better Care, Improved Outcomes

Last year, researchers reported that long-term care hospitals (LTCH) provide superior outcomes for the most severely ill patients than any other post-acute care setting

“Post-acute care plays a significant role in our health care system,” explains George Kyriacou, MSPH, president and CEO of Gaylord Hospital in Wallingford, Conn, during a September 2018 presentation of a study, based on 2016 data from the Centers for Medicare and Medicaid (CMS), during the American Medical Rehabilitation Providers Association Educational Conference and Expo in Boston.

 Highest Severity of Illness

“In 2016, approximately 43% of Medicare beneficiaries who were discharged from an acute-care hospital went on to receive post-acute care from skilled nursing facilities, home halth agencies, inpatient rehab facilities or long-term care hospitals,” adds Kyiacou.


 Kyiacou observed, “But when we analyze the range of patient acuity—or the rating that is given to each patient based on the severity of their illness with a rating of ‘1’ being the least ill and ‘4’ being the most severely ill—found in each post-acute care setting, it is clear that long-term care hospitals disproportionately shoulder the care of the largest population of the highest severity of illness compared to any other post-acute care setting.”

“On average, 57.1 percent of all patients in a long-term acute care hospital in 2016 were considered by Medicare to be of the highest acuity,” he continues, in a media release from Gaylord Specialty Healthcare. “In comparison, only 15.8 percent of the nation’s skilled nursing facilities’ patient population was comprised of patients of the highest acuity,” says Kyiacou.

Although the study findings indicated that LTCH care for an overall sicker population, these facilities provide significantly better outcomes for patients when compared to those with the same severity of illness recovering in other post-acute settings.  The researchers found up to 15.4 percent fewer hospital admissions, up to 30.6 percent longer time for readmission and up to 31.7 percent lower outpatient emergency room utilization rates.

“The Medicare data demonstrates what LTCHs have known all along: our nation’s sickest patients achieve significantly better outcomes in long-term care hospitals than in any other post-acute care setting,” Kyriacou continues.

The data and conclusions outlined in the study come in stark opposition to the conclusion of a National Bureau of Economic Research (NBER) working paper, “Long-Term Care Hospitals, a Case Study in Waste,” released in August 2018, according to the release.

“Our findings do not align with the results of the NBER study which suggests that Medicare could realize $4.6 billion per year in savings with no harm done to patients by not allowing for discharge to LTCHs,” Kyriacou notes.

According to Kyiacou, based on his research, LTCHs are important to a “healthier, safer health care system” and are a vital resource for the nation’s sickest patients.



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