Episode Overview

Podcast: Becker’s Healthcare Podcast
Episode Title: The Role of Long-Term Acute Care Hospitals and Partnerships in High-Acuity Care
Release Date: January 6, 2026
Host: Erica Spicer Mason (A)
Guest: Dr. Daniel Del Portal, Senior Vice President and Chief Clinical Officer, Temple Health (B)

This episode explores the critical role of Long-Term Acute Care Hospitals (LTCHs) in the continuum of care, focusing on how partnerships between health systems and LTCHs can optimize patient outcomes, relieve capacity pressure, improve financial sustainability, and support the transition of complex patients. Dr. Del Portal shares real-world examples, operational strategies, and future perspectives based on his leadership at Temple Health.

Key Discussion Points & Insights

1. Understanding LTCHs and Their Place in Care Continuum

[01:51]

• Dr. Del Portal describes the specific patient population LTCHs serve:
  • LTCHs focus on patients with serious medical conditions needing extended hospital-level care (average stays: weeks to months).
  • Distinction from short-term acute care hospitals (average stay: about a week or less).
• LTCHs provide specialized services such as:
  • Ventilator weaning
  • Tracheostomy care
  • Intensive respiratory care
  • Slow progression to rehabilitation or home

Quote:

“LTCH really specialize in the care of patients with serious medical conditions that are going to require extended hospital level care. Usually it’s more than 25 days.” – Dr. Del Portal [02:29]

2. Value Added by LTCHs Over Short-Term Acute Care Hospitals

[04:11]

• Problems with keeping medically complex patients longer in short-term hospitals:

  • Reduced access and capacity due to bed shortages, prolonged ED boarding—a national crisis.
  • Financial strain due to DRG-based under-reimbursement for complex, prolonged stays.
  • Suboptimal patient experiences and risk of patients being "trapped" in the wrong care environment.

• LTCHs as a solution:

  • Provide targeted, resource-intensive care (ventilator weaning, ongoing complex treatments) without competing with acute emergency needs.
  • Facilitate smoother recoveries and thousands of acute care hospital days saved.

Quote:

“By moving to a setting designed to focus on the longer term… the patient can often have a better experience than if the short term hospitalization was prolonged for months and months.” – Dr. Del Portal [06:54]

3. Examples of Conditions and Real-World Impacts

[08:29]

• Dr. Del Portal’s evolving understanding:

  • LTCHs are frequently underestimated or lumped together with skilled nursing facilities, but have broader clinical capabilities.
  • They can handle tracheostomy changes, feeding tube management, blood pressure support, even some ICU-level needs.

• Patient Story:

  • Critically ill patient with aortic dissection stabilized in acute hospital but needed prolonged ventilator and feeding tube support.
  • Transitioned to Kindred LTCH, spent 28 days, weaned off ventilator, had trach and feeding tube removed, transitioned to regular diet, moved to acute rehab, and eventually went home.
  • This transition saved significant acute hospital bed days and was only possible due to the robust capabilities of the LTCH.

Quote:

“We had one patient who had suffered a really serious aortic dissection… through our partnership with Kindred LTCH, we were able to transfer him there. And he, over the next 28 days, got multidisciplinary support… he ultimately transitioned from the feeding tube to a regular diet…” – Dr. Del Portal [09:17]

4. Operational Benefits and Data Integration from LTCH Partnerships

[11:00]

• Key partnership practices:

  • Sharing outcome metrics (time from referral to acceptance, length of stay, readmission rates)
  • Involving Temple’s specialty physicians (e.g., pulmonologists) in weekly rounds at LTCH
  • EMR integration: tracking eligible patients, coordinating with liaisons and case management
  • Supporting families and smoothing the transition process

• Results:

  • Increased clinical confidence in LTCH capabilities
  • Improved care coordination and quality

Quote:

“Having a robust partnership, I think does have a really important impact on hospital operations and clinical quality.” – Dr. Del Portal [12:38]

5. Looking Ahead: Future of LTCH Partnerships and Continuum of Care

[13:11]

• Healthcare trends:
  • Hospitals face growing complexity: population needs, social determinants, value-based/risk-based care, rising costs.
  • Shrinking margins make efficient resource use essential.
• LTCH partnerships as a bridge:
  • Free up acute hospital beds for emergencies, enable recovery in the right setting.
  • Future likely sees LTCHs expanding their role as acuity and patient needs increase.

Quote:

“Part of my job is looking at where the gaps are in that continuum of care and finding sustainable ways to provide ongoing care outside the short term acute care hospital… my experience with LTCH is that they can serve as a really helpful role in bridging patients who are too sick for home, rehab or skilled nursing but don’t really need all the resources of a short term acute care hospital.” – Dr. Del Portal [13:46]

6. The Importance of Trust and Feedback in Partnerships

[15:37]

• Physician concerns:
  • Need confidence that patients are well cared for after discharge.
  • Strong partnerships built on feedback, data sharing, and genuine collaboration.

Quote:

“The best partnerships we have are truly focused on patients needs and they’re attentive to those expert physician opinions and those of other caregivers.” – Dr. Del Portal [16:18]

Notable Quotes & Highlights With Timestamps

• [02:29] “LTCH really specialize in the care of patients with serious medical conditions that are going to require extended hospital level care. Usually it’s more than 25 days.” – Dr. Del Portal
• [06:54] “By moving to a setting designed to focus on the longer term… the patient can often have a better experience than if the short term hospitalization was prolonged for months and months.” – Dr. Del Portal
• [09:17] “We had one patient who had suffered a really serious aortic dissection… he ultimately transitioned from the feeding tube to a regular diet…” – Dr. Del Portal
• [12:38] “Having a robust partnership, I think does have a really important impact on hospital operations and clinical quality.” – Dr. Del Portal
• [13:46] “My experience with LTCH is that they can serve as a really helpful role in bridging patients… who don’t really need all the resources of a short term acute care hospital.” – Dr. Del Portal
• [16:18] “The best partnerships we have are truly focused on patient needs and attentive to expert physician opinions.” – Dr. Del Portal

Timestamps for Key Segments

| Timestamp | Segment/Topic | |------------|----------------------------------------------------------------------------------------------| | 01:51 | What LTCHs are and patient types they serve | | 04:11 | National challenges with acute care capacity, financial aspects, and access | | 08:29 | Conditions effectively treated in LTCHs, misperceptions, patient anecdotes | | 11:00 | Operational impacts and best practices for LTCH-health system partnerships | | 13:11 | Future outlook for LTCHs in the care continuum | | 15:37 | Importance of trust, feedback, and the human element in post-acute partnerships |

Conclusion

This episode provides a deep dive into the operational, clinical, and strategic importance of LTCHs in the modern health care continuum. Dr. Del Portal’s insights highlight the value of strong partnerships, data-informed transitions, and trust across providers, ultimately ensuring the right level of care and supporting health system sustainability as patient populations become more complex.