Volume 3, Issue 3, Fall 2015

IN THIS ISSUE:The New LTAC Criteria Law is Upon Us! .......................... 1-2Understanding Community Admissions ..................................2Medical Advisory Board Members Announced .......................3National Medical Directors Clinical Conference Moves to Fall ............................................................................3

THE NEW LTAC CRITERIA LAW IS UPON US! Almost two years ago Congress passed what has become known as the “LTAC criteria law.” Although this new law will be phased in over several years, it was initially anticipated it would begin taking effect at most LifeCare hospitals in September 2016. We subsequently learned the new law will take effect on a rolling basis in January 2016! ThefirstLifeCarehospitalsto“golive”withtheLTACcriteria law on Jan. 1, 2016, will be our North Texas, Pittsburgh and Wisconsin facilities. Needless to say, planning for the changes needed to comply with the LTAC criteria law has been accelerated considerably. This legislation, which is a financial definition ratherthanaclinicaldefinitionoflongtermacutecare,spellsoutthespecificrequirementsforapatienttobeconsidered“compliant” versus “site neutral.” As daunting or complex as this process may seem, it actually represents an outstanding opportunity for LifeCare hospitals to broaden the breadth and scope of services we offer to a much wider variety of patients while increasing our flexibilitytomanagepatientsrequiringvariablelengthsofstay.What does this mean for our traditional long term acute care patients? LifeCare will continue to provide extended acute care services for our chronically critically ill patient populations as we have always done. Although extended acute care for the chronically critically ill and medically complex patients will remain a core competency for our hospitals, the new LTAC criteria law allows us the opportunity to provide care to additional populations of patients that we previously were precluded from serving.

The LifeCare Family of Hospitals5340 Legacy DriveSuite 150 - Building 4Plano, Texas 75024469.241.2100469.241.2199 Fax

We are building a company that cares for each patient’s body, mind and soul.www.lifecare-hospitals.com

Page 4, Fall 2015

ABOUT THE AUTHOR: T. BRIAN CALLISTER, MD, FACP, FHMDr. Callister is National Medical Director for LifeCare Hospitals, with 24 locations in nine states. For more information, please contact Janeen Foreman, LifeCare’s Director of Case Management, at 469-241-5140.

What is the opportunity for treating new populations of patients? Patients who neither stay in an ICU prior to a LifeCare hospital admission nor utilize invasive mechanical ventilation for 96 hours or longer will no longer be factored into the old 25-day length of stay requirement. This means patients who need transitional care services or relatively shorter acute care hospitalizations can be cared for at a LifeCare hospital. For example, consider the large number of chronic heart failure and COPD patients who would benefitfrom a short stay or an extended stay in either an acute care and/or a transitional care setting. With the advent of the new LTAC criteria law, these deserving patients may be eligible for admission to our hospitals for short, medium or longer stays depending upon their individual clinical needs. Their care needs will be met in an individualized fashion that factors in each patient’s unique care requirements in alignment with both their level of acuity and functional status. By blending our acute and critical care concepts with a personally tailored therapy program, we believe each of our patients will have the best opportunity possible for a successful outcome while maximizing their functional status.

Volume 3, Issue 2, Summer 2015

LifeCare PhysiCian In thIs Issue:LifeCare Announces Medical Advisory Board ..........................1

LifeCare Begins Physician CDI Training ....................................1

A Busy Year Ahead for LifeCare Physicians! ............................2

New Patient Satisfaction Partner for LifeCare .........................3

LIfeCare announCes MedICaL advIsory Board The LifeCare Family of Hospitals has announced the formation of a Medical Advisory Board or “MAB.” Over the last several months we have been developing the process and structure to create this small work group that will interface with LifeCare’s senior executive team. In addition to our existing LifeCare national physician committees, the MAB will be a brand new high level group comprised of six LifeCare physicians from around the country representing different specialties of care. The mis-sion will be to provide analysis and feedback to LifeCare’s senior management team on clinical issues, projects and strategic plans for the company.

The MAB will be an exciting and dynamic group charged with being the official “sounding board” for the most im-portant clinical planning and implementation ideas across the LifeCare system. It will also be a critical resource for discussing future growth plans throughout the post-acute continuum – both for LTAC and other levels of post-acute care, as well as for possible partnership and joint venture opportunities). The six physician members of the new MAB were recently selected for their expertise in the post-acute continuum in specialty areas representing pulmonary medicine, hospitalists, wound care, infectious disease, physical medicine and rehabilitation, nephrology, and medical staff issues (MEC/credentialing/bylaws/ policies). The group is expected to be fully functional

by early fall. n

LifeCare Management services

The LifeCare Family of Hospitals5340 Legacy DriveSuite 150 - Building 4Plano, Texas 75024469.241.2100469.241.2199 Fax

We are building a company that cares for each patient’s body, mind and soul.www.lifecare-hospitals.com

Page 4, Summer 2015

aBout the author: t. BrIan CaLLIster, Md, faCP, fhMDr. Brian Callister is the National Medical Director for the LifeCare Family of Hospitals with 24 locations in nine states. For more information, please contact Janeen Foreman, LifeCare’s Director of Case Management, at 469.241.5140.

LIfeCare BegIns PhysICIan CdI traInIng LifeCare Hospitals has rolled out an extensive Clinical Documentation Improvement (CDI) program for physi-cians and hospital staff. This education project will be ongo-ing and will incorporate training needed to improve current documentation in the medical record to better reflect our patients’ acuity. In addition, the CDI program will provide an opportunity to prepare for the implementation and roll-out of ICD-10 in Fall. As part of the CDI launch, the designated Physician CDI Advisors for each LifeCare facility recently gathered in Plano, Texas, for an initial in-depth education program. Run in parallel with our annual LifeCare National Medical Directors meeting, the Physician CDI Advisor initial training included more than six hours of CME-approved course work, as well as a chance to network with LifeCare’s medical directors and senior executive management team. Each local Physician CDI Advisor will now be working closely with the facility CDI nurse to educate the medical staff and to be a resource for documentation and coding issues and questions at each of our facilities. Follow-up CME approved CDI education sessions for physicians will be taught over the summer and into the autumn at each of our hospitals. Please be on the lookout for an invitation to an upcoming program for your facility and plan to attend! n

The MAB will be the official “sounding board” for the most important planning and implementation

ideas across the LifeCare system.

Continued on page 2

Page 2, Fall 2015 Page 3, Fall 2015

STARS Specificity, Teamwork, Accountability,

Results and Sustainability These are the key components to LifeCare’s clinical resource

management program focusing on the impact

of documentation.

Please join me in thanking these physicians for their willingness to participate in this important role.

A patient admission to an LTAC hospital from a lower level of care or from home within 30 days of a STAC hospital discharge should not count against

the STAC hospital’s readmission rate.

UNDERSTANDING COMMUNITY ADMISSIONS

THE NEW LTAC CRITERIA LAW... MEDICAL ADVISORY BOARD MEMBERS ANNOUNCED

NATIONAL MEDICAL DIRECTORS’ CLINICAL CONFERENCE MOVES TO FALL

With the new LTAC criteria law coming on line in the near future, there has been confusion regarding “communityadmissions”toLTAChospitals.Specifically,the question has been asked, “if a patient is discharged from a short term acute care (STAC) hospital to the community (home, home with home health, skilled nursing facility, etc.) and is then admitted to an LTAC hospital within 30 days of the STAC discharge, does this count as a ‘readmission’ to acute care for the STAC hospital?” Much of the confusion arises because STAC and LTAC are both “acute” care settings. However, the STAC readmission criteria specifically state that an admissioncounts as a “readmission” only if it is an “applicable” hospital. For purposes of the Hospital Readmission Reduction Program by Medicare, “an ‘applicable hospital’ includes subsection (d) hospitals, which is the statutory reference for STCHs paid under the inpatient hospital prospective payment system (IPPS), but not LTCHs and other hospitals excluded from the IPPS.” i

The bottom line is that a patient admission to an LTAC hospital from a lower level of care or from home within 30 days of a STAC hospital discharge should not count against the STAC hospital’s readmission rate. As such, LTAC hospitals should continue to be a viable option for extended acute care for appropriate patients who are failing or deteriorating after discharge from a STAC hospital.

i See Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Fiscal Year 2014 Rates, 78 Fed. Reg. 50,496, 50,657 (Aug. 19, 2013)

LifeCare recently announced the creation of a new Medical Advisory Board (MAB) comprised of a small number of physicians representing different specialty areas and diverse LTAC experiences to advise the National Medical Director and LifeCare Senior Executives on a variety of issues related to long term acute care quality delivery, strategic growth, and technical issues.

MAB physicians will hold their initial meeting with LifeCare senior executives in Plano, Texas, on November 12. Topics will include the new LTAC criteria law, standardized order set development, quality outcomes assessments and reporting, critical technical capabilities, and clinical care maps. It is anticipated the MAB will continue to meet in person two to three times per year with additional conference call meetings held in between each meeting.

The Annual LifeCare National Medical Directors Clinical Conference is moving to fall! Medical directors from local LifeCare facilities and physicians who sit on some of LifeCare’s physician committees have been asked to attend the meeting in Plano, Texas, on November 13. This CME event will immediately follow the new Medical Advisory Board meeting scheduled for November 12. Physicians from both groups will gather on the evening of November 12 at a dinner hosted by LifeCare’s senior executive team. Representing the largest gathering of LifeCare LTAC physicians each year, the annual clinical conference is a chance to learn what’s new and on the cutting edge in quality,efficiencyandpublicpolicyforLTAChospitalcare.It also provides an excellent opportunity to network with fellow LTAC physician leaders and LifeCare management in a relaxed and interactive forum.

This year’s conference will focus on the new LTAC criteria law that becomes effective on Jan. 1, 2016 (although it will be phased in over several years). Although education will also be provided at each LifeCare hospital, medical directors who attend the conference will play a critical role in leading the education of their fellow LifeCare physicians about the opportunities and challenges of the new LTAC criteria law.

LifeCare is extremely appreciative of the dedication and commitment these physician leaders are

willing to provide to improve the care of all of our deserving LTAC patients.

Webelievehavingtheflexibilitytoprovideindividualizedcare plans that range from extended critical and acute care to transitional care in our hospitals will likely reduce readmissions and improve outcomes. And this will allow our patients the chance to be treated in an environment with personalized programs – based on each patient’s needs – with the ability to adjust their care over time as they improve.

The new LTAC criteria law is upon us, and we are excited about the opportunities it will provide to expand the breadth, depth and quality of LifeCare services to a much larger population of deserving patients! Please look for more information and educational programs on these new criteria that will be offered at our local facilities in the very near future. As always, thank you for all you do for our patients each and every day!

Continued from page 1

The LifeCare physicians asked to serve on the new MAB are:• Dr. Richard Beers, Dayton• Dr. Randall Bell, San Antonio• Dr. Robert Crossey, Pittsburgh• Dr. Glenn Herrmann, Denver• Dr. Michael Jackson, Reno-Tahoe• Dr. Andrew Krinsky, Sarasota• Dr. Michael Nammour, Ruston

In a very real and tangible way, the new LTAC criteria law offers a tremendous opportunity to help a much wider population of patients that

varies widely in regard to diagnosis, care needs, therapy needs and length of stay