Community Hospital Corp. Subsidiary Readies 5 LTACHs

ContinueCARE hopes to demonstrate that long-term acute-care hospitals can provide cost-efficient care for the 2% to 3% of patients who require long-term acute care after discharge from acute care hospitals.

A Community Hospital Corporation subsidiary is finalizing its plans to open or expand seven long-term acute-care hospitals in four states in 2015.

The expansions directed by CHC ContinueCARE come in the midst of a three-year federal moratorium on new LTACH hospitals that was slipped into the Protecting Access to Medicare Act of 2014 at the last moment.

Leslie Boney, CHC's senior vice president of Post-Acute Services, says the Plano, TX-based hospital and healthcare services company secured the seven exemptions before the moratorium went into effect and that all seven projects will be launched in 2015.

Five of the LTACHs would be new developments located in Charlotte, NC; Madisonville, KY; Paducah, KY; Odessa, TX; and Bakersfield, CA. In addition, CHC has secured LTACH status for a facility it operates in Midland, TX, and has filed for a bed expansion at its LTACH in Abilene, TX.

"What is spurring us to want to grow is that it's an underserved patient population," Boney says. "We are finding there are a lot of pockets in the United States that are truly underserved. For example, we are doing two different hospitals in western Kentucky, in Madisonville and Paducah. We put them there because western Kentucky did not have an LTACH and when we did the analysis, we found a need for more than 200 LTACH beds."

"Unfortunately, that will be the end for the three-and-a-half-year moratorium before we can begin looking for other opportunities," she says.

Under the typical LTACH model, Boney says CHC ContinueCARE rents a floor from a short-term acute care hospital.

"The reason you want to do that is for efficiencies that will allow us to purchase lab and radiology and use all the services that are currently in the short term acute versus trying to create them again and having that increased cost," Boney says. "For continuity of care you have the same physicians when you go from short term acute to long term acute."

Boney says CHC ContinueCARE hopes to demonstrate that LTACHs can provide cost-efficient care for the 2% to 3% of patients who require long term acute care after discharge from acute care hospitals. The majority of the LTACH patients are elderly and on Medicare.

"Our patients are there for 25-to-30 days. It's not a huge volume of patients but that patient population will always be there," she says.

"The opportunity of the extended acute stay is just to make sure you get those patients to the point that they can go to a post-acute program that can do it safely, so they can go home and stay home versus bouncing back to acute care again."

The alternative to LTACHs means that short-term hospitals must either hold patients longer or discharge them into inappropriate settings and risk readmissions. "It's a release valve for short-term acute. These patients still need that long stay and there is just no other avenue for them in this market," she says.

"There will always be this group of patients who aren't going to do well in the short-stay environment. This is just an opportunity to give them a level of care the need for that extended stay."