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Long term acute care facilities fill vital role in insurance crisis


Government and private health insurance programs limit the number of days that patients can be hospitalized in an acute care hospital. For critically ill patients who need care longer, the answer can be staying in a “hospital within a hospital” that might even be managed by a different company specializing in long term acute care (LTAC).

Two such examples in the state are the LTAC facility operated by Regency Healthcare on the fifth floor of the Forrest General Hospital in Hattiesburg, and Promise Hospital of Vicksburg, which operates in the same building as the Merit Health River Region hospital.

“What we do is specialize in medical management of critically ill and medically complex patients,” said Mike McMillin, vice president of physician relations and education, Promise Hospital of Vicksburg, which is part of the Promise Healthcare network of 20 LTAC hospitals nationwide. “Once they are discharged from acute care, we keep them for a longer period and finish that treatment. We specialize in cardio pulmonary care, complex wound care, and rehabilitation therapies such as physical therapy, occupational therapy and speech therapy. Our patients require intensive treatment, daily on-site physician assessments and an individualized approach to recovery.”

McMillin said they focus on achieving excellent patient outcomes by taking an interdisciplinary team approach to care. Their team includes an attending physician, nurses, respiratory therapists, wound care specialists, occupational therapists, speech pathologists, physical therapists, a pharmacist and dietitian. As a hospital within a hospital, they have their own dietary department, their own pharmacists, a respiratory management team, and an aggressive wound care team.

“All of these health care professionals work together and play an active role in each patient’s treatment and recovery,” he said.

McMillin said they take of critically ill patients who require aggressive clinical and therapeutic intervention on a 24-hour, seven-days-a-week basis. The medical team uses specialized treatment programs designed to treat patients with multiple medical complexities. He said these programs are not generally available or appropriate for traditional hospitals or sub-acute facilities.

“Upon admission, our interdisciplinary team meets to discuss each patient’s medical conditions, create a specific treatment plan and set recovery goals,” McMillin said. “The team then meets weekly to chart each patient’s progress and ensure that patients are well on their way to achieving the best possible outcome.”

The 35-bed Promise Hospital of Vicksburg, which opened in 2003, has about 150 employees. So, in addition to providing advanced, specialized care, the hospital also has a big economic impact on the community. And a benefit for patients and their families is not having to travel to a large area to receive treatment.

Some conditions that meet criteria for being hospitalized in a LTAC facility include debilitating complex wounds, post-surgical complications, multi-organ failure, needing to be weaned from a ventilator, spinal cord or severe head injuries and the need for IV antibiotics to treat infectious diseases.

There are no other LTAC hospitals within a 50-mile radius. That allows Vicksburg area families to have access to visit loved ones in the hospital without traveling long distances.

“We recognize the importance of family and friends as essential team members in supporting and encouraging the patient during treatment and recovery,” McMillin said. “Because patients are in the hospital for longer stays, staff get to know the patients and families better. I do know that the staff we have provide compassionate care. I’ve frequently heard from patients and families that the staff make the patients feel like family.”

McMillin said there are still limits on the number of days government or private insurance will pay for a patient to be in a LTAC facility.

“Typically, patients stay about 30 days,” he said. “Patients come to LTAC with the goal of going home or sometimes placement in a nursing home or assisted living situation.”

McMillin said another benefit to LTAC hospitals is that they cut down on the average length of stay in acute hospitals decreasing their average length of stay, which positively affects reimbursement rates. It also frees up beds for new patients.


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