ArrayThe scope of enduring care, the benefits of long-term acute care hospitals, and what the shift in demographics means to the viability of the industry

The need for durative care is not going anywhere. As the makeup of the American population continues to shift toward a top-heavy, senior-laden demographic, long-term care is set to become a defining focal point of this and of future generations. The writing is on the wall: In 2007, 9 million men and women over the age of 65 required one form or another of long-term care. By 2020, 12 million will require such services.

While we wait for the vast waves of Americans to spill into older age groups, the focus today rests on the existing options and transitions that are able to provide the smoothest roads for our patients. In the diverse landscape of long-term care, which is both a common and expensive latelife option, which services will best serve you or your patients?At its most fundamental, long-term care is a set of services that addresses medical or non-medical needs of people with chronic disease or disability. In most cases, the goal of long-term care is to grant individuals an optimal level of functioning. Long-term care options like skilled nursing facilities and assisted living facilities focus on the quality of daily living rather than striving for a cure.

One long-term care institution, however, does the exact opposite. Known as long-term acute care hospitals, or LTACs in the jargon of the industry, these facilities provide extended treatment for some of most severe and complex conditions seen in the folds of the health care canvas. The goal of LTACs is to help patients recover and return them home to their former way of life.

Whether an LTAC is a good fit for a patient can be determined largely by medical complexity, says Robin Lester, a senior director of case management at Kindred Healthcare, which operates more than 80 LTAC hospitals around the country. “Most of our patients have one primary diagnosis and 16 or more complications or comorbidities,” Lester says. “They are pretty complex medical patients, which is why they necessitate, on average, a 25-day length of stay.”

Length of stay is one requirement of admission. Other hallmarks of the LTAC hospital include a requisite amount of skilled nursing hours per day and the availability of specialized equipment.

“Long-term acute care hospitals have a vital role in the overall health care continuum,” says Adriane Lutes, senior vice president of operations for Select Specialty Hospital, which operates close to 90 LTAC hospitals in 25 states. “Select Specialty Hospital is designed for medically complex and critically ill patients who require a longer acute-care stay than a traditional hospital usually can offer.”

Before negotiating the specific elements of LTACs and how they differ from other forms of long-term care, it is important to understand the environment in which these facilities and services can engage and prosper.