Referral Triggers Any ONE of the following may trigger referral to LTAC after a five-day acute care LOS: Multi-system disease processes – e.g. diabetes, heart failure Frequent change in condition – e.g. increasing or decreasing oxygen saturation, diuretic needs, fluid balance Frequent medication changes – e.g. cardiac meds, repeated IV bolus of Mg or KCL Positive blood or fluid cultures (CSF, sputum) Patients who are positive for osteomylitis TPN patients with ileus or swallowing problems (need for speech therapy, nutritional analysis, frequent labs) Obese patients with poor respiratory status (hypoventilation) or who need CPAP or BiPap (sleep apnea) Surgical patients with postoperative complications (ileus, respiratory instability, pain control problems, wound infection) Orthopedic patients with complications (MI, diabetic control) Complicated diagnosis – e.g., new CVA with old head injury, multiple pathways Fragile medical conditions – e.g., respiratory problems plus new MI, COPD or CHF plus pneumonia Mechanical ventilation – invasive or noninvasive Any TWO of the following may trigger referral to LTAC after a five-day acute care LOS: Recent stay in ICU or step-down unit High oxygen requirements (>5 liters/min) Debrided wound Complex wound processes – e.g., lymphedema, cellulites Infected wounds Wounds requiring whirlpool treatment or pulse lavage New tracheostomy Patients requiring frequent pain management (IV or pump) Patients requiring frequent physician monitoring (daily vs. weekly) Patients with frequent hospital admissions Patients with reported downward course at home over the past several months Patients who are NPO for a lengthy time (>7-10 days) Nutritional issues – e.g., decreased albumin, decreased protein, underweight, obese, cachexic Multiple wounds Nursing home patients with need for complex management Patients with evidence of deconditioning Inappropriate Candidates for Referral: Patients refusing to participate in therapy Patients with end-stage disease – e.g., extensive cardiomyopathy (EF<20%), cancer with metastasis Patients with mental health issues Simple disease processes with short treatment course Patients without LTAC reimbursement benefits To Make a Referral If you have a patient whom you believe is an appropriate candidate for the LTAC level of care, you can refer him/her via one of the following convenient ways: By phone at 404.501.6226 By fax at 404.501.6334 Online via Allscripts Referral system (participating healthcare facilities only) A member of our staff will perform an assessment at no charge and help you determine if your patient meets our admissions criteria. The assessment can be conducted at an acute-care hospital, in a nursing home, in the physician’s office or at the patient’s home. To schedule an assessment, call 404.501.6262.