Long-term acute care facility
A long-term acute care facility is a hospital specializing in treating patients requiring extended hospitalization. In the United States, such institutions have proliferated since the 1980s, partly because of incentives created by Medicare reimbursement.[1] Professor Jeremy M. Kahn, MD, currently (2015) of the University of Pittsburgh School of Medicine Heath Policy Institute[2] as quoted in the New York Times said “The U.S. health care system allows unintentional financial incentives to drive sweeping changes,” and further said LTACs "exploit" Medicare.[1]
Criticisms
Patients needing extended care and the patient's families are often told LTACs provide superior care, but there seems to be not only no objective evidence of this, but in fact, evidence to the contrary.[1] For example the frequency with which patients develop serious infections in LTACs is more than 3 times as great as in conventional hospitals.[1] Unlike traditional hospitals LTACs often have no physicians on hand overnight.[1] "Long-term care hospitals, which have grown rapidly in the last 25 years, are cited as having almost twice the number of Medicare violations as standard hospitals, and also have higher incidents of bedsores and infections."[3]
The motivation for transferring patients to LTACs appears to be purely financial, because Medicare rules make long term patients a money losing proposition for conventional hospitals but a money making proposition for an LTAC.[1] LTACs receive a substantial fee (averaging $40,000 USD as of 2009) just for accepting a new patient from a traditional hospital and the traditional hospital opens up a bed for a more profitable patient.[1] This can happen even if the LTAC and the traditional hospital are in the same building and the transfer consist merely of paperwork and wheeling the patient from one room to another.[1]
