The Long Term Acute Care Hospital (LTACH) unit at Madonna Rehabilitation Hospital offers patients with complex medical conditions access to physical medicine and rehabilitation and daily visits by internal medicine physicians. Combined with an interdisciplinary team approach, this specialized care ensures that each patient's plan of care is targeted at achieving functional gains and independence.
Patients on LTACH receive a wide array of services including physical, occupational, speech, recreational, respiratory and nutritional therapies, rehabilitation nursing, rehabilitation psychology, spiritual services, orthotic/prosthetic services, case management, social work and other services depending upon the unique needs of each individual served. Therapies are provided, on average, 2 hours per day during week days with supplemental therapy on the weekend. Registered nurses with rehabilitation experience are involved with care 24 hours per day, seven days per week. Patients on LTACH are seen daily by an internal medicine physician. Consultations with physicians with training in physical medicine and rehabilitation (called "Physiatrists" ) and other medical specialties such as pulmonology or wound care are provided as needed.
Madonna serves adults with a wide variety of complex medical conditions resulting in activity limitations and participation restrictions on LTACH. Cultural diversity is respected. Most patients transfer to Madonna directly from an acute care facility, and are expected to be medically stable although still quite acutely ill. Madonna accepts funding from Medicare and most commercial payers. Nebraska Medicaid does not recognize the LTACH level of care.
LTACH patients are expected to discharge to a lower level of care, including community settings, acute rehabilitation hospital, or skilled nursing facilities. For specific outcomes, please click on the outcomes button.
Licensed as a hospital and accredited by CARF, the Rehabilitation Accreditation Commission. LTACH is a 96-bed unit that offers treatment for acute illnesses which require a longer time to recover than is generally provided in an acute care hospital.
To be eligible for admission to LTACH, the patient must have a(n):
- Pulmonary condition requiring acute respiratory therapy, ventilator support with the potential to wean, C-PAP/Bi-PAP, tracheostomy, or oxygen greater than 4 liters per minute
- Complex medical condition requiring controlled IV medications (e.g. heparin, dopamine, morphine pump, or insulin drip or multiple IV medications administered more frequently than three times per day.
- Nutritional deficit requiring support of TPN and/or lipids
- Post-operative skin graphs and flaps, stage 3-4 wounds or multiple stage 2 wounds requiring treatment at least daily or assessment and/or interventions by a medical specialist involved in wound care, a specialized bed and/or a wound vac
- Renal condition requiring initiation of dialysis or established dialysis with one other qualifying condition
- Major multiple trauma, neurological disorder (e.g. multiple sclerosis, polyneuropathy, muscular dystrophy or Parkinson's Disease) or stroke diagnosis with complications initially limiting participation in the physical restorative services of physical, occupational, and/or speech therapy to less than 3 hours per day.
- Cardiac condition, including: CABG, MVR, AVR, Post-acute MI, Coronary Stents, or new pacemaker with comorbidity
- Need for daily internal medicine physician visits and 24 hour medical and rehabilitation nursing care
As a hospital, Madonna provides the following:
Pharmacy Madonna's in-house pharmacy is open Monday -Friday 8 am to 10 pm and 8 am to 430 pm on weekends and holidays. During closed hours, a pharmacist is on call. Madonna provides a full range of inpatient pharmacy services, including medication distribution (both oral solids and IV preparations), patient education, clinical/dosing services and participation in several hospital committees. Madonna does not supply take home medications for patients and patients who require parenteral chemotherapy are sent out to a patient infusion center for that service.
Respiratory Therapy Madonna provides respiratory therapy 24 hours per day, seven days per week using Madonna staff who are licensed respiratory care practitioners. Madonna's respiratory therapists provide ABG services. Pulmonologists perform bronchoscopies on-site with assistance from respiratory therapy staff.
Laboratory Madonna's in-house laboratory is open from 7 am to 7 pm Monday - Friday and 7 am to 330 pm on weekends. On Christmas and New Year's day, the laboratory is open from 7 am to 1 pm. Madonna's laboratory provides anticoagulation, hematology, chemistry, therapeutic drug level testing, and urine analysis services. Additional testing, if necessary, is provided by the Physicians Laboratory Services. Most general lab tests are performed by the Madonna Lab and results are provided the same day. Send-out tests, such as cultures and less common tests, are resulted in 3-5 days.
Radiology Madonna provides limited in-house radiology services, including X-ray, Echocardiogram, Venous Doppler, Arterial Doppler, Holter Monitor, Sleep Study, and EEG. CT scans, MRI, Ultrasound, and any other comprehensive radiology exams are performed at one of the medical facilities in Lincoln. Regular hours for Madonna's radiology department are 8:30 am to 9 pm Monday-Friday and 8:30 am- 5 pm on weekends. Patients are transported to one of the medical facilities in Lincoln if they require services after those hours. Results of in-house testing are interpreted by Radiology Associates, PC and in most cases reported the same day.
To learn more about each of the specialized programs that operate on Madonna's LTACH unit, please click on one or more of the following links:
