TABLE 1

Types of Post–Acute Hospital Care for Adult and Pediatric Patients

Adult Patients
Long-term acute care (LTAC): LTACs provide care for hospitalized patients with >1 complex chronic condition who are ready for hospital discharge but require ongoing skilled nursing care for health issues such as cardiac recovery, ventilator dependency, cancer care, and wound care. Patients admitted to LTAC are not ready for inpatient rehabilitation. However, they are eventually expected to improve enough to benefit from rehabilitation (ie, they will eventually experience transfer to a rehabilitation facility) and to return home. To enter an LTAC facility, patients are expected to stay at least 25 days. LTAC patients typically transfer from an ICU. LTAC nursing staff is typically available 24 h a day.
Inpatient rehabilitation: inpatient rehabilitation facilities admit patients from acute care hospitals who have neurologic, musculoskeletal, and/or cardiopulmonary impairment and who are ready for intensive, active rehabilitation. Rehabilitation patients are admitted with a high likelihood that they will exhibit improvement in the areas of self-care, mobility, safety, communication, cognition, and behavior before discharge from the rehabilitation facility. Rehabilitation patients typically receive an intense specified number of rehabilitation therapy hours per day (eg, at least 3 h) for 5–7 d per week with emphasis on specific functional goals. Rehabilitation nursing staff is available 24 h a day.
Subacute care: subacute care is an alternative setting of rehabilitation for patients ready for some degree of rehabilitation but not the intensive, active rehabilitation offered by an inpatient rehabilitation facility. Subacute rehabilitation patients typically receive less than 3 h of rehabilitation per day, and the rehabilitation is often focused on 1 particular goal (eg, eating or toileting). Nursing services in a subacute care facility may not be provided for a full 24 h a day
Pediatric Patients
Pediatric post–acute care: the types of post–acute care for children are not as distinct as the types for adult patients. Pediatric post–acute care facilities admit children from acute care hospitals. They provide long-term inpatient care for children who (1) remain too debilitated or unstable to be discharged from the hospital and require ongoing hospital-level of medical care (eg, to wean ventilator support, complete IV antibiotic administration, wean medications); and (2) who have a prognosis for improvement in the areas of self-care, mobility, safety, communication, cognition, and behavior before discharge from the rehabilitation facility and require an intense specified number of rehabilitation therapies per day. Rehabilitation patients typically receive a minimum of 3 h per day for 5–6 d per week with an emphasis on functional goals. Rehabilitation nursing staff is available 24 h a day. Pediatric post–acute care hospitals are also referred to as pediatric specialty hospitals or pediatric rehabilitation hospitals.
  • Adapted from the Association of Rehabilitation Nurses.