Care Coordination: Expediting ICU Discharges for LTACH-Appropriate Patients

When medically complex patients require hospital care, they tend to experience longer recovery times than other patients do and are more likely to readmit to the ICU.^1,2

Kindred Hospitals, a network of long-term acute care hospitals (LTACHs), is focused on reducing lengths of stay in the ICU and readmissions for medically complex patients by enhancing our care coordination. By working closely with case managers and discharge planners in the ICU to identify LTACH-appropriate patients, our clinical liaisons can help expedite discharges, to the benefit of both patients and hospitals.

Reducing Discharge Delays

Studies have demonstrated a link between unnecessary discharge delays and negative outcomes such as hospital-acquired infections, reduced patient independence, and an overall reduced quality of life.³

For medically complex patients, particularly those requiring mechanical ventilation, it is critical that they begin receiving care at a long-term acute care hospital as soon as possible. As one study indicates, a one-day delay in discharge to the long-term acute care hospital after intubation is associated with an 11.6% reduction in the odds of weaning.⁴

With increased care coordination, Kindred Hospitals can help identify patients who may be ready to start receiving specialized acute care. Facilitating timely transitions also opens critical care beds faster, improving hospital throughput and easing emergency department boarding challenges.

Reducing Readmissions

When medically complex patients transfer to LTACHs, they receive specialized acute care and rehabilitation that can reduce their risk of readmission. This is supported by data that breaks down readmission rates by patient acuity, as measured by Hierarchical Condition Category scores.⁵ The data show the average readmission rates for patients in the High or Very High HCC tiers (higher acuity) are about 50% lower at LTACHs than at traditional hospitals.⁶

Reducing readmission rates is also an important strategic goal for hospitals. Readmissions cost an estimated $57.7 billion annually in care, in addition to penalties incurred as part of CMS’ Hospital Readmissions Reduction Program.⁷ In 2023, CMS applied penalties worth $320 million for high readmission rates.⁸ Hospitals therefore benefit from ensuring that patients receive the level of care that most closely aligns with their medical needs.

Benefits of Choosing Kindred Hospitals

When LTACH-appropriate patients choose to transfer to a Kindred Hospital, patients and physicians benefit from the following:

Authorizations: We have a team of authorizations specialists who are trained in payor-specific criteria and turnaround times for improved first-pass authorizations. We also have robust denials-management capabilities that help patients gain access to the hospital of their choice.

Expert Care: Patients at Kindred benefit from physician-led interdisciplinary care and specialized rehabilitation. Our care includes:

• Interdisciplinary care team bedside rounds: Caregivers gather at the patient’s bedside to discuss patient goals, milestones, and progress.
• Early Mobility: Kindred patients receive rehabilitation therapy, to the degree they are able, from physical and occupational therapists, as well as speech-language pathologists, even while receiving acute care.
• Certifications from The Joint Commission: Disease-specific certifications ensure a standardized, evidence-based approach to treatment and performance improvement.
• AfterCare Program: Representatives follow up with patients after they leave our hospital to answer questions about discharge orders, medications, or follow-up appointments.

Physician Updates: Kindred physicians offer referring physicians real-time updates, with patient consent, as well as regular performance reporting and discussion.

Kindred Hospitals’ focus on improved care coordination is designed to efficiently and effectively help such patients move to the most appropriate care setting as soon as possible, so that they can achieve optimal recovery and return to the lives they love.