Long-Term Care Hospitals: What the Data Shows

What Is This Type of Facility

Acute care for patients who need weeks, not days.

A long-term care hospital is a federally designated acute care hospital where the average patient stay must exceed 25 days — a threshold written directly into the Social Security Act.¹ That threshold influences who gets admitted, how care is delivered, and how Medicare pays for it.

Importantly, the 25 days is a facility-level average across all Medicare patients, not a minimum stay for each individual. Some patients leave in two weeks. Others stay two months. What matters to CMS — and what this designation is built on — is whether the facility as a whole is consistently serving patients who need extended hospital-level care.

The patients here are not recovering from a routine procedure. They are typically transferred from an intensive care unit — dependent on a ventilator, fighting a severe infection, too unstable for a rehabilitation facility or nursing home. The goal is not just to keep them stable, but to get them well enough to leave.

What the Data Covers

Five areas of measurement — each asking a different question about quality of care.

The federal government reports quality data on long-term care hospitals quarterly. The measures fall into five natural groups. Each group reflects a different dimension of care — from whether patients are leaving the hospital at all, to whether the facility is keeping them safe while they are there.

🏠

Getting Patients Home

The most fundamental question: what share of patients are successfully discharged back to their home or community, rather than transferred to another institution? This measure is risk-adjusted — it accounts for how sick patients were when they arrived.

Discharge to home or community rate
Risk-adjusted rate with confidence interval
Comparison to national average

🔄

Readmissions After Discharge

When a patient leaves a long-term care hospital and ends up back in an acute care hospital within 30 days, that is a potentially preventable readmission. This measure tracks how often that happens — and whether it happens more or less than expected for this facility's patient population.

30-day potentially preventable readmission rate
Risk-standardized rate
Comparison to national average

🫁

Ventilator Care

Long-term care hospitals are the primary setting in the country for weaning patients off mechanical ventilators. Three measures track this specifically: whether patients were assessed for readiness, whether they received breathing trials, and whether they were ultimately freed from the ventilator during their stay.

Assessment for breathing trial readiness
Patients who received breathing trials
Ventilator liberation rate
Change in mobility for ventilator patients

🛡️

Infections and Patient Safety

Long hospital stays come with infection risk. Three federally tracked infections — catheter-associated urinary tract infections, central line bloodstream infections, and C. difficile — are reported using a standardized infection ratio that compares each facility's actual infections to the number predicted given their patient population.

Catheter-associated urinary tract infections (CAUTI)
Central line bloodstream infections (CLABSI)
C. difficile infections
Falls with major injury
New or worsening pressure injuries

💊

Care Transitions and Medication Safety

What happens when a patient leaves matters as much as what happens while they are there. These measures track whether medications were reviewed and flagged issues followed up on, and whether a complete medication list was passed to the next care setting and to the patient and family at discharge.

Medication review with follow-up on issues identified
Medication list provided to next care setting
Medication list provided to patient and family at discharge
Discharge function score — ability to care for self

💰

Medicare Spending

Medicare reports what it spends per patient episode at each long-term care hospital, standardized to account for differences in local cost of living. A score above 1.0 means this facility costs more than the national average for similar patients. A score below 1.0 means it costs less.

Medicare spending per beneficiary score
Number of eligible episodes

About the Data

Where the data comes from and how often it is updated.

All quality data for long-term care hospitals is published by the Centers for Medicare and Medicaid Services as part of the Long-Term Care Hospital Quality Reporting Program. Facilities that participate in Medicare are required to submit this data — making coverage broad across the roughly 300+ facilities that currently report.

The data is updated quarterly. Most measures reflect a rolling 12-month collection window. The two outcomes measures — readmissions and discharge to community — are based on 24 months of data and refreshed annually. Data collection windows and release timing vary by measure — some reflect the past year, others up to 24 months prior. Historical releases are preserved, making it possible to track how a facility's performance has changed over time.

Sources

Section 1886(d)(1)(B)(iv)(I) of the Social Security Act — CMS Long-Term Care Hospital PPS