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Pandemic preparedness: Long-term acute care (LTAC) challenges

August 06, 2021
Business Affairs
Mike Hodge
By Mike Hodge

As hospitals reach capacity in the treatment of COVID-19 patients who are suffering the lingering effects of the virus (e.g., damage to the lungs, heart, kidneys, gut, liver), they are turning to long-term acute care (LTAC) facilities to fill the gap in patient care. However, one has to ask if these facilities are prepared for the challenges of caring for these complex patients?

Depending on a facilities’ capacity, many may lack the equipment and supplies to manage the clinical complexities of COVID-19 cases. None of the chronic care facilities have had to provide this level of care in the past. Compounding this issue, the pandemic has intensified long-standing challenges in the LTAC space, including high operational costs and staffing shortages.

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Even long-term acute care hospitals (LTACHs), which are typically well equipped to provide high-acuity care, have opportunity to advance and promote improved patient outcomes. In a study of 94 LTACHs caring for COVID-19 patients, published in the December 2020 edition of the journal CHEST, the researchers determined that:

(While) “LTACH staff have the skills necessary for treatment of COVID-19 patients, extensive preparations and transformations are required for treating patients with a highly virulent virus.”

LTAC administrators bear the burden of preparing their facilities and staff members for long-term care of COVID-19 patients. Here are some factors for consideration that can help LTAC facilities deliver high quality care at a lower cost.

Start with a safe transition
Safely transitioning a COVID-19 patient from an acute-care hospital to a LTACH, skilled nursing facility (SNF) or other long-term care site is key to maintaining continuity of care. It requires close communication and collaboration between the hospital discharge planner and LTAC facility administrators.

One challenge LTACs face is converting patients from the hospital’s medical equipment and supplies to their own. There are inherent risks in switching a patient from one therapeutic (e.g., ventilator) or diagnostic (e.g., monitor) device to another, particularly when the new device is designed for lower acuity care. Additional challenges arise when a patient comes from the hospital to the post-acute care setting with accessories and consumables that are not compatible with the post-acute site’s equipment.

By aligning medical supplies and equipment to hospital ICU standards, a long-term care facility can enhance the quality of care delivery, help facilitate healthy patient transitions and minimize safety risks. For those facilities that are part of a larger health system, standardization of equipment and supplies to a single vendor can also reduce costs.

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