GAO Report Highlights Key LTACH Oversight Differences

January 10, 2011

On Dec. 22, 2010, the Government Accountability Office (GAO) released a report highlighting key differences in federal oversight standards among long-term acute care hospitals (LTACHs) and certain other classes of hospitals and skilled nursing facilities. The report was prepared in response to the Senate Finance Committee’s initiation of a formal investigation in March 2010, after a Feb. 10, 2010, New York Times article described patient deaths and allegations of substandard patient care at one of the nation’s largest LTACH providers.

The report includes a summary of the GAO’s findings and CMS’s comments, and highlights differences in four areas: (1) Medicare and Medicaid participation requirements; (2) quality standards; (3) surveys; and (4) enforcement of quality standards. The report notes that CMS is in the process of developing LTACH-specific hospital conditions of participation in response to requirements in the Medicare, Medicaid and SCHIP Extension Act of 2007. CMS may propose new long-awaited rules by May 2011 addressing the LTACH patient admission and discharge process, staffing requirements, and the levels of patient care provided in LTACHs.

It’s worth noting that representatives from the LTACH industry’s two trade organizations, the Acute Long Term Hospital Association and the National Association of Long Term Hospitals, are also working with The Joint Commission, an accreditation organization responsible for oversight of approximately 95% of the nation’s 434 LTACHs, to develop new LTACH-specific accreditation criteria.

The GAO report doesn’t conclude the Senate Finance Committee’s investigation of the LTACH industry, but it’s unclear what additional action the committee will take. Please contact one of the authors, if you have any questions about the impact of the report on your organization or LTACH providers.