Long Term Care hospitals (LTCHs) are hospitals that are classified under acute care but majorly focus on patients that stay in hospital for more than twenty five days. Most of the patients in Long term care hospitals are brought from intensive care unit, and who are likely to be suffering from more than one acute condition but show signs of improving with time and care. The main services in this facility are full rehabilitation, respiratory treatment, trauma and pain administration.
LTCHs have several sources of reimbursement at their disposal that include traditional and modern methods. Financing of LTCHs is a crucial factor in provision of delivery items and manpower in the institution. Source of funds for maintenance of these hospitals come from federal state, state, private dollars and insurance companies. The Medicaid, the biggest insurance for the poor is the major reimbursement institution for long term care hospitals. Medicare provides reimbursement to these hospitals though in a small margin through the support of long term untrained individual care. Private long term insurance companies also contribute a small percentage of the bill in these hospitals which is approximately six percent. Though there are several stakeholders involved in reimbursement of funds in Long term care hospitals, much of the bills are paid by the public and private dollars which comes directly from the consumer (Banaszak-Holl, J., and Hines. M. A, 1996).
According to Congressional Budget Office (1999), all the stakeholders in these hospitals including decision makers, doctors and consumers recognize the need for financing while maintaining the standards and quality of services in these institutions. The urge to provide quality services and maintenance has increased the necessity for provision of services. A number of initiatives have been done by federal, state and other stakeholders to run LTCHs by integrating services in a number of ways. There is no agreeable standard way of integration but most stakeholders agree that integrated services have to include the following: wide and flexible services, broad delivery channels that surpass what traditional hospitals offer, implementation of mechanisms that incorporate care like centralized records, adoption of quality control systems with centralized accountability and flexible financing that is characterized by minimizing costs. These modes of cooperation and integration have been adopted by LTCHs and its effects are quite positive (Gage, B., M. Moon, L. Nichols, et al., 1997).
The challenge that remains with long term care hospitals is to do with management responsibilities. There is need for change so that the target of providing quality care services to patients is achieved while at the same time providing services at a lower cost. For LTCHS to achieve these targets stakeholders must understand the process of healthcare identifying strengths and weaknesses then focus on strengths so that the issue quality and costs are addressed. The process of providing healthcare in LTCHs entails use of a wide variety of resources by patient with both acute and common diagnosis as well as focusing of attention to an individual. The biggest focus in healthcare has been given to adoption of new techniques and procedures that better the quality of services and reduce cost (Colves, A., and M. Blanchet, 1983).
Long term care for patients suffering with chronic illnesses and disabilities still remains a challenge to be addressed around the globe. Despite the fact that families play a bigger role in taking care of this patients, states have to avail resources to counter the growing demand and distribute it equitably and efficiently. The society should be involved in designing the ethical framework upon which equitable and rational decisions are made in long term care hospitals (Atchley, 1996).
Atchley, R.C. (1996). Frontline Workers in Long-Term Care: Recruitment, Retention, and Turnover Issues in an Era of Rapid Growth. Oxford, Ohio: Scripps Gerontology Center.
Banaszak-Holl, J., and M. A. Hines. (1996). Factors Associated with Nursing Home Staff Turnover. Gerontologist, 36(4):512-7.
Colves, A., and M. Blanchet. (1983). Potential Gains in Life Expectancy Free of Disability: A Tool for Health Planning. International Journal of Epidemiology, 12(2):224-9.
Congressional Budget Office. (1999). CBO Memorandum: Projections of Expenditures for Long-Term Care Services for the Elderly. Washington, D.C.
Gage, B., M. Moon, L. Nichols, et al. (1997). Medicare Savings: Options and Opportunities. Washington, D.C.: Urban Institute.