Long-Term Care Hospitals (LTCHs or LTACs)
Everyone is familiar with the typical acute care hospital, where most people stay for a relatively short time. This is where we go when we need hospital treatment for emergency care, an acute illness, or surgery. Most acute care hospitals want to discharge their patients as soon as possible, so hospital stays are usually fairly short (there are always exceptions, of course).
Some people need hospital care for a longer period, and this is where long-term care hospitals (LTCH) come in. LTCHs are designed to work exclusively with patients with certain diagnoses who have an average stay of 25 days, which is much longer than the general acute care hospital average.
Many LTCH patients arrive directly from an intensive care or critical care unit in a general hospital. Others transfer to a long-term care hospital when their acute care physicians feel they are ready for discharge, but would benefit from continuing skilled medical care and/or intensive therapy.
LTCHs specialize in the care of specific conditions which generally require longer hospital stays. Patients commonly have one or more of the following diagnoses:
Renal insufficiency or renal failure
Wound care needs
Spinal cord injury
Severe weakness or malnutrition
Congestive heart failure
LTCHs are covered by Medicare just as acute care hospitals are covered. Under Medicare, the patient is only responsible for one deductible in any hospital benefit period. A benefit period begins the of hospital admission and ends when the patient has not received any inpatient care in a hospital or medicare-covered skilled nursing facility for 60 days in a row. This applies whether the care was received in an acute care hospital or an LTCH.
If a patient with Medicare is transferred to an LTCH directly from an acute care hospital, or if the patient is admitted to an LTCH within 60 days of being discharged from an inpatient hospital stay, and if the patient has paid the deductible for the previous inpatient stay, there is no second deductible reqired for care in a LTCH. It is all considered part of one benefit period.
If the patient is admitted directly to the LTCH more than 60 days after any previous hospital stay, the patient would be responsible for paying the same deductibles and coinsurance as he would have paid if he were being admitted to an acute care hospital.
If the patient has the Original Medicare Plan and a Medigap (Medicare Supplement) insurance policy, some of the deductible or coinsurance costs may be covered. Medicare Advantage Plans have different ways of covering LTCH care, and most will require pre-approval, so you should contact your plan for more information.