A long-term acute-care hospital (LTACH) treats medically complex patients who need hospital-level care for an extended stay — often after the ICU, for needs like ventilator weaning. It is a hospital, not a nursing home. CMS certifies just 317 LTACHs across 47 states and territories.
What an LTACH is
An LTACH is a hospital certified to care for patients whose recovery takes far longer than a typical acute stay — defined by an average length of stay greater than 25 days. These facilities run critical-care-level services and specialized programs, most notably prolonged ventilator weaning, complex wound care, and management of multiple serious conditions at once. They sit between the acute hospital and lower-intensity post-acute care.
Who it is for
LTACH patients are medically complex and frequently transfer directly from a hospital ICU. They need continued hospital-level care — a ventilator they must be weaned off, multi-system organ support, severe infections needing weeks of IV antibiotics, or extensive wounds. The common thread is sustained instability that a short-stay hospital is not structured to manage and a nursing home cannot.
LTACH vs IRF vs skilled nursing
- Hospital-level medical complexity
- Extended stays (avg > 25 days)
- Ventilator weaning, organ support
- 317 facilities
- Intensive therapy, ~3 hrs/day
- Medically stable patients
- Functional recovery focus
- 1,221 facilities
- Lower-intensity nursing + rehab
- Longer, flexible stays
- Broad post-acute care
- Thousands of facilities
What Medicare covers
Because an LTACH is licensed as a hospital, Medicare Part A covers a medically necessary stay as inpatient hospital care under the long-term-care-hospital payment system, subject to the inpatient deductible and applicable cost-sharing. Coverage depends on the patient meeting the medical-necessity criteria for continued hospital-level care over an extended period.
How CMS measures LTACHs
LTACHs do not carry a single five-star rating. CMS publishes individual quality measures — outcomes, complication and readmission indicators, and reporting compliance — on Care Compare. With so few facilities, families and discharge planners often weigh location and program fit alongside the measures; every value can be traced to its CMS source.
By the numbers
Compare LTACHs
Browse certified long-term acute-care hospitals and their quality measures — each field traced to its CMS source and snapshot date.
Browse LTACH data →Frequently asked questions
- What is a long-term acute-care hospital?
- A long-term acute-care hospital (LTACH or LTCH) is a Medicare-certified hospital that treats medically complex patients who need hospital-level care for an extended period — generally an average length of stay greater than 25 days. Patients often arrive after an intensive-care stay, needing things like prolonged ventilator weaning. CMS lists 317 certified LTACHs across 47 states and territories.
- How is an LTACH different from a regular hospital?
- An LTACH is a hospital, but it is built for the long, complex recoveries that a short-stay acute hospital is not structured to manage. It provides ongoing physician care, critical-care-level services, and specialized programs such as ventilator weaning over weeks rather than days. LTACHs are rare — 317 of them — compared with 5,426 general hospitals.
- What is the difference between an LTACH and an inpatient rehab facility?
- Both are hospital-level post-acute settings, but the focus differs. An LTACH manages ongoing medical complexity and instability — multiple organ issues, ventilator dependence, complex wounds. An inpatient rehab facility focuses on intensive therapy for functional recovery in patients who are medically stable enough for roughly three hours of therapy a day. There are 317 LTACHs and 1,221 IRFs.
- Who is admitted to an LTACH?
- LTACH patients are medically complex and often come straight from a hospital ICU. Common needs include prolonged mechanical ventilation and weaning, complex wound care, multi-system organ support, and serious infections requiring extended IV therapy. The defining feature is the need for continued hospital-level care over an extended stay.
- Does Medicare cover a long-term acute-care hospital stay?
- Yes. Medicare Part A covers medically necessary LTACH care under its own hospital payment system, subject to the inpatient deductible and applicable cost-sharing. Because an LTACH is licensed as a hospital, the stay is covered as inpatient hospital care when the patient meets the medical-necessity criteria for that level of care.
- How do I compare long-term acute-care hospitals?
- Certified LTACHs report quality measures on CMS Care Compare, and Fonteum mirrors those records with the source and snapshot date on each field. You can compare facilities on the published measures and confirm certification against the federal source. Because LTACHs are scarce, location and program fit often matter as much as the measures.
Related
- What is an inpatient rehabilitation facility? — the therapy-intensive hospital-level setting.
- What is a skilled nursing facility (SNF)? — the lower-intensity post-acute option.
- What Medicare certification means — how an LTACH becomes a certified Medicare provider.
- LTACH facility data — per-facility CMS quality measures with provenance.
- Hospital quality data — the general-hospital records for comparison.
- The CMS Five-Star Quality Rating — which settings carry a star, and which report measures instead.