Understanding Long Term Acute Care Hospital Admission Criteria: A Comprehensive Guide

Long-term acute care hospitals (LTACHs) provide specialized treatment for patients with serious and complex health needs that require ongoing treatments. They are built to offer ongoing, intensive care for patients who are stable but still need close monitoring, specialized therapies, or complex treatments. LTACHs make sure the patients get just the right care for as long as they need it.

With chronic illnesses on the rise and an aging population, more people than ever are relying on LTACH services. In fact, each year, over 100K hospitalized patients are transferred to an LTACH facility to recover in the U.S. alone. That is why understanding LTACH admission criteria is important to better align patient care with their health needs. It ensures patients are in the best place for their recovery. Thus, minimizing unnecessary transfers and maximizing the care they receive.

In this article, we will learn more about long-term acute care hospital admission criteria.. We will also share a tool, AdmissionCare that can help you streamline the overall admission process in your healthcare facility.

What Are Long Term Acute Care Hospitals?

LTACHs are healthcare facilities for patients with serious medical conditions who require extended hospital stays and acute care. Typically, such patients stay in the hospital for over 25 days. These facilities are a must for individuals who need specialized care beyond what traditional hospitals can provide.

LTACH can be an independent healthcare facility or a unit within a regular hospital. The goal of an LTAC unit is to help patients achieve maximum recovery through proper medication and nursing care. 

Patients who are typically admitted to LTACHs have serious medical conditions that require specialized treatment and ongoing medical attention. This includes patients requiring:

• • IV therapy for medication administration
  • Mechanical ventilation for respiratory failure or ventilator weaning
  • Ongoing dialysis and management of chronic kidney or renal issues
  • Pre-organ and post-organ transplant care
  • Complex wound care and management
  • Infection management
  • Post-surgical acute care

LTACHs differ greatly from traditional hospitals and skilled nursing facilities. While traditional hospitals focus on acute care for shorter durations, LTACHs specialize in providing care for patients who are stable but still require intensive support. This makes LTACHs essential for patients who are too stable for traditional care but who are not yet ready for home care or less intensive rehabilitation.

As a more detailed example, a patient recovering from severe pneumonia could be treated in an LTACH where they receive the right respiratory therapy along with continuous monitoring rather than sending them home. This will offer them an extended recovery period without any additional complications.

Long Term Acute Care Hospital Admission Criteria

LTACHs need to be utilized appropriately for patients so they can benefit the most from their specialized services. These patients are no longer appropriate for lower level-of-care but are fit to receive custodial care. To ensure that the right patients receive long-term acute care, LTACH admission criteria have been introduced. 

The LTACH admission guidelines assist healthcare providers in making the most appropriate treatment-related decisions for their patients. These admission guidelines involve evaluating several key criteria to determine if a patient is suitable for this specialized care.

#1. General Admission Criteria

As the name suggests, the general admission criteria focus on your patient’s existing medical conditions and care requirements. Admission into an LTACH facility is considered to be medically necessary when all of the below-mentioned criteria are met:

• • Physician orders for an LTACH admission.
  • Acute care cannot be safely provided at home or in a community setting. This might be because of a lack of experience, the type of care required, or the unavailability of necessary equipment. 
    • For instance, if your patient requires any of the following medical interventions, they may qualify for admission into an LTACH facility. 
      • Ventilator
      • Trach care
      • Chest tubes
      • IV drips or IV antibiotics
      • Frequent suctioning
      • Complex wound care
      • Telemetry
  • The care has to be provided by qualified providers of respective skilled services like direct physician monitoring or specialized clinical staff.

#2. Condition-Specific Indications

Besides general criteria, LTACH admissions often depend on condition-specific indications. The physician needs to confirm the diagnosis or conduct a complete evaluation of the patient. This could include an entire physical examination, medical history analysis, review of relevant laboratory reports, diagnostic testing, and the patient’s response prior to therapeutic intervention. The anticipated results of the recommended intervention may also be provided. 

To request the LTACH service, all this information must be presented in clinical documentation that reflects:

• • the patient’s health situation at the time of the requested service.
  • the healthcare provider’s clinical intent behind these actions.

That being said, let us explore the various condition-specific indications in detail.

• • Ventilator management – Patients who require ventilator support or respiratory care anytime during their recovery process.
  • Complex wound management – Patients who have complex wounds that need to be assessed regularly for extensive management.
  • Cardiovascular conditions – Patients with severe heart diseases or those recovering from complex cardiac procedures that require ongoing monitoring and rehabilitation.
  • End-stage renal disease and dialysis – Patients with acute medical conditions related to renal diseases.
  • Severe infectious disease conditions – Patients having infectious diseases like meningitis, sepsis management, and more requiring IV antibiotics and monitoring for clinical deterioration.

#3. Patient Stability

The patient’s condition of being sufficiently stable or their stability also plays an important role in determining if they qualify for admission to an LTACH. 

• • Clinical stability – Patients must be medically stable and not experience any significant fluctuations in their health status at any point in time. This allows healthcare providers at LTACH to focus on rehabilitation and care rather than actually managing the medical condition.
  • Response to treatment – Patients must respond to previous treatment plans and show signs of improvement in their health conditions. For instance, the heart rate and blood pressure must be within acceptable limits without the risk of any life-threatening conditions.
  • Monitoring needs – Patients must require continuous monitoring and observation from a multidisciplinary team of physicians, nurses, and rehabilitation specialists. 
  • Recovery potential – Patients must show some positive signs of recovery potential or likelihood that specialized care offered at LTACH will nurse them back to health. 

#4. Patient Prognosis

Patient prognosis or expected prognosis also determines the admission or continuation into the LTACH facility. Healthcare providers are required to document anticipated outcomes based on the patient’s health status and expected recovery plan. By assessing the expected recovery trajectory, they can gauge how likely the patient’s condition will improve with specialized care. 

Prognosis focuses not just on immediate recovery but also on long-term outcomes. It takes into account factors like the patient’s age, coexisting health issues, severity of primary condition, and more to determine if patients need prolonged care. Further, it promotes multidisciplinary assessment by various healthcare professionals to evaluate the patient’s condition and develop a personalized care plan.

However, patient prognosis can change based on the patient’s response to ongoing treatment. Hence, it requires continuous monitoring and reevaluation, thereby warranting adjustments to care plans to facilitate an early discharge.

How EvidenceCare Can Streamline the Admission Process

Navigating the complex admission processes can be quite challenging for healthcare providers. Ensuring that the patients meet the required admission criteria, managing the patient documentation and their medical records, coordinating treatment plans within multidisciplinary teams, and more can lead to delays in patient admissions. This indirectly impacts patient care and their overall recovery process. 

EvidenceCare offers comprehensive clinical decision support (CDS) software that can streamline this complex admission criteria. AdmissionCare is an  advanced  solution that  provides evidence-based criteria and guidelines in the admitting clinician’s EHR workflow. This ensures appropriate medical necessity documentation for  patients admitted to the healthcare facility. AdmissionCare reduces administrative burden and facilitates quicker decision-making.

EvidenceCare can:

• • Automate the patient documentation process to ensure quicker evaluation for hospital admissions.
  • Promote collaboration among multidisciplinary teams such as the UR team and physician advisors to discuss patient care. 
  • Present up-to-date guidelines for inpatient vs observation patient status decisions and support informed decision-making.
  • Generate reports for tracking admission trends, operational efficiency, patient outcomes, and more to ensure improvements in care delivery.

Integrating AdmissionCare into your admission process will certainly improve your overall efficiency and improve patient admission decisions. Schedule a demo to learn how our solution can help your hospital.

FAQs