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What is a Transitional Care Hospital?

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Published on Mar 13, 2013

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 was complicated, or who carry the burden of chronic illness even when home. Sometimes called chronically critically ill, these patients require specialized and aggressive goal-directed coordinated care over an extended recovery period.

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 the typical five-day stay for patients in traditional hospitals.

When a family or a referring physician is trying to decide the best post-acute setting for a particular patient, they are typically looking at a transitional care hospital, a nursing home or a 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 best directed by a physician, in a transitional care hospital, a nurse-led team in a skilled nursing facility, or 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, dieticians, and pharmacists, all working together to best coordinate 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? 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 TCH 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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