[20060314]RS22399_影响长期护理医院的医疗保险最新发展.pdf

Congressional Research Service The Library of CongressCRS Report for CongressReceived through the CRS WebOrder Code RS22399March 14, 2006Recent Developments in Medicare Affecting Long-Term Care HospitalsSibyl TilsonSpecialist in Social LegislationDomestic Social Policy DivisionSummaryMedicare pays about $36 billion annually for post-acute care in four separatesettings: long-term care hospitals (LTCHs), inpatient rehabilitation settings (IRFs),skilled nursing facilities (SNFs), and in the home. Medicare pays for care in each settingunder a unique payment system that uses different patient assessment instruments (PAI)to establish a patients level of care. LTCHs, often considered the most expensive post-acute care setting, are not required to use any PAI. Generally, Medicare requires thatLTCHs be licensed as acute care hospitals and have an average length of stay of 25 days.Although there is no prior hospitalization requirement in order for a Medicarebeneficiary to qualify for care in an LTCH, approximately 80% of beneficiariesreceiving such care are transferred from an acute care hospital. LTCHs provideintensive care to patients who have multiple, coexisting conditions who may needho