Definition of a Long Term Care Hospital (LTCH)
A LTCH is “…’a hospital which has an average inpatient length of stay (as determined by the Secretary of Health and Human Services)) of greater than 25 days.’”[i] A LTCH is not the same as a nursing home. Also, according to a Medpac congressional report[ii], “The Congress and the Secretary should define long-term care hospitals by facility and patient criteria that ensure that patients admitted to these facilities are medically complex and have a good chance of improvement."
Identifying Long-Term Care Hospitals in the Medicare Data
Several Medicare files contain LTCH stays or claims including:
- MedPAR Research Identifiable File (RIF)
- MEDPAR Limited Data Set (LDS) - Hospital (National)
- Long-Term Care Hospital (LTCH) PPS Expanded Modified MedPAR LDS
- Inpatient RIF and
- Inpatient LDS
The Medicare Provider Number (PRVDRNUM in MedPAR or PROVIDER in Inpatient) variable identifies LTCH stays or claims. The last four numbers of the LTCH Medicare Provider Number will have numbers between 2000-2299. The LTCH PPS Expanded Modified MedPAR LDS is a subset of the MedPAR LDS file and only contains LTCH stays.