What is a Transitional Care Hospital?

I am often asked what is a transitional
care hospital. A transitional care hospital is an acute care hospital that
specializes in the treatment and rehabilitation of patients who require a
prolonged length of stay due to complex medical problems. Transitional care
hospitals are certified by Medicare as long-term acute care hospitals and about
two-thirds of our patients have Medicare. Transitional care hospitals are unique
in their ability to care for patients whose surgery or medical treatment has
proven difficult, whose Hospital course has been complicated, or who carry a
burden of chronic disease even when at home. Sometimes called chronically
critically ill, these patients required specialized and aggressive goal-directed
coordinated care over an extended period of time. Most come to us from traditional
short-term acute care hospitals. Typical patients have multiple ongoing illnesses
and many have multi-organ system failure and have experienced a significant loss
of Independence. Transitional care hospitals are full fledged hospitals.
They are accredited by the Joint Commission to the same standards as
traditional community and university hospitals. They are licensed by the state
as acute care hospitals with additional Medicare certification that supports a
length of stay measured in weeks as compared to a typical five-day stay for
patients in traditional hospitals. When a family member or referring physician is
trying to decide the best post-acute care setting for a particular patient
they are typically looking at a transitional care hospital, a nursing
home or rehabilitation center. One way to make a choice is to ask yourself who
needs to direct this patient’s care on a daily basis. Is it directed by a
physician in a transitional care hospital, by a nurse-led team in a
skilled nursing facility, or by rehab specialists in a rehabilitation center?
Transitional care hospitals are the right place for patients who need to see
a doctor or several doctors every day. The care patients receive at a
transitional care hospital is interdisciplinary with input from many
different kinds of specialists, from doctors and nurses to occupational and
physical therapists, speech and language pathologists, dietitians, pharmacists,
all working together to best coordinate the care so that it is safe, effective
and efficient. The team looks at each patient individually to decide what are
the best options for treatment and what are reasonable goals to work toward over
the next few days and weeks. The team asks itself, knowing the patient’s
physical condition, function, mental state and personal wishes, what do we think
this patient can look like in three days, seven days or two weeks. This is not an
answer that any one medical professional knows on his or her own. They need a team. Kindred’s transitional care hospitals have had great success in reducing
readmissions to acute care hospitals, and government studies show that choosing a
transitional care hospital reduces the odds of readmission by almost half. Fewer readmissions relieves stress on patients and also saves money for Medicare, and
insurers. At Kindred we do this every day, all over the country, and believe that
with us each patient and family will find hope, healing, and recovery.

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