LTACHs vs. SNFs: Which Care Setting is Better for Medically Complex Patients?
Kindred Hospitals provide specialized long-term acute care and rehabilitation for medically complex patients. With physician-led, interdisciplinary care and disease-specific certifications from The Joint Commission, we provide seriously ill or injured patients with the high-quality acute care they need, for the time they need it.
Learn more about the conditions that often lead to a transfer to Kindred Hospital.
Complex respiratory conditions that may require ventilator weaning, including but not limited to:
- Acute respiratory distress syndrome
- Acute respiratory failure
- Airway burns
- Aspiration pneumonia
- Chronic ventilation with increased reliance on support
- Complicated pulmonary infections
- COPD/emphysema
- COVID
- Failed weaning attempts at acute care setting
- Interstitial lung disease/pulmonary fibrosis
- Post-COVID conditions
Top 5 Conditions by Setting1
LTACHs
- Pulmonary edema and respiratory failure
- Respiratory system diagnosis with ventilator support for 96+ hours
- Respiratory system diagnosis with ventilator support ≤96 hours
- Respiratory infections and inflammations with major complication or comorbidity
- Other respiratory system O.R. procedures with major complication or comorbidity
SNFs
- COVID-19
- Metabolic encephalopathy
- Urinary tract infection, site not specified
- Sepsis, unspecified organism
- Pneumonia, unspecified organism
Within the Top Conditions Treated at LTACHs…
- More than 20% of cases require ventilator support
- 40% of cases are characterized by the top two pulmonary DRGs
- Septicemia or severe sepsis with major complications or comorbidities is one of the top 10 conditions
- 16 of the top 20 conditions include at least one major complication or comorbidity
Comparing Patient Complexity at LTACHs and SNFs
Additional insight into patient differences in each setting can be gained by looking at the Hierarchical Condition Category (HCC) codes of patients at LTACHs and at SNFs. HCC coding is a risk-adjustment model that helps communicate patient complexity, with higher scores reflecting greater complexity.2
The Advisory Board categorizes Medicare patients into Low, Mid, High, and Very High HCC tiers. According to recent data, 83% of LTACH patients fell into the High or Very High HCC tiers, while only 38% of SNF patients were in those categories.3 This suggests that LTACHs have greater experience treating medically complex patients.
With this greater experience, LTACHs have achieved improved outcomes for medically complex patients. The same data reveals that the average readmission rates for patients in the High or Very High HCC tiers are about 2X higher at SNFs than at LTACHs.
Kindred Hospitals provide specialized long-term acute care and rehabilitation for medically complex patients. Demonstrating our commitment to excellence, each of our hospitals has achieved at least one disease-specific care certification from The Joint Commission in either Respiratory Failure, Pulmonary Rehabilitation, Sepsis, or Wound Care.
With initiatives such as our Move Early program of early mobility and our AfterCare program of post-discharge follow-up communications, we are dedicated to helping our patients achieve lasting recovery.
Learn more about how Kindred Hospitals can help you manage your medically complex patients.
References
- FY 2022 CMS Medicare Claims
- https://www.advisory.com/blog/2018/04/reimbursement
- The Advisory Board. The Post-Acute Care Pathways Explorer. State Average Outcomes by HCC Score Tier. HCC tiers include Medicare FFS patients with a total HCC score in the following ranges: ‘Low’ between 0 and 2, ‘Mid’ greater than 2 and less than or equal to 4, ‘High’ greater than 4 and less than or equal to 6, and ‘Very High’ greater than 6. Accessed November 2023.
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