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Dr. Jeremy M. Kahn of the University of Pennsylvania has received a federal grant to study long-term care hospitals, and the results are not good.

Long-term care hospitals are theoretically best for those patients who are too sick for a nursing home but need longer-term care than traditional hospitals are willing to provide. However, in 2007 and 2008, long-term care hospitals were cited for serious violations of Medicare rules at a rate about twice that of traditional hospitals. Many of the long-term care hospitals also do not have a physician on staff. Additionally, unlike traditional hospitals, Medicare does not financially penalize these long-term care facilities if they fail to submit quality data to the government.

Why do hospitals then discharge these patients and send them to a long-term care hospital? Money. Nearly all of the long-term care hospitals in the United States are owned by for-profit companies. Under Medicare payment rules – and a vast majority of patients at long-term care hospitals are medicare patients – traditional hospitals often lose money on patients who stay for long periods, and the long-term care facilities receive financial incentives from Medicare for patients who are treated for 25 days or more. Thus, both the traditional hospital and the long-term care hospital gain financially from the current climate. The only person who loses is the patient.

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