AHA: What is a long-term care hospital's role in treating 'long COVID-19'


The policy director of the American Hospital Association, the CEO of a Chicago-area long-term hospital and a pulmonologist discussed the role of treating patients experiencing "long COVID-19" in an AHA podcast published April 14.

The AHA's policy director, Rochelle Archuleta, spoke to Jim Prister, president and CEO of RML Specialty Hospital, AHA board of directors member and chair of AHA's post-acute steering committee, and John Votto, DO, pulmonologist and former CEO of New Britain, Conn.-based Hospital for Special Care, to examine the role long-term hospitals have played for patients that continue to have COVID-19 symptoms, but no longer have the active COVID-19 virus.

Ten things to know about long-term hospitals' role in treating post-acute COVID-19 patients:

  1. Dr. Votto said he defines acute long-haulers of the illness as the phase where symptoms last between four and 12 weeks. However, some patients are considered post-acute long-haulers, where their symptoms last more than 12 weeks.

  2. Dr. Votto said 87 percent of hospitalized COVID-19 patients continued to have symptoms at 60 days post-COVID-19.

  3. Around 10 percent of hospitalized patients who are discharged end up being rehospitalized, Dr. Votto said.

  4. Mr. Prister said that during the pandemic, many hospitals that referred patients to his long-term facility needed to relieve the growing demands on their ICU. RML began to treat a much higher level of active ICU patients.

  5. RML found that COVID-19 patients in the second wave were sicker and experienced longer recovery times. The hospital ended up having a waiting list to admit patients.

  6. RML found that 44 percent of all admissions across three programs are post-COVID-19 patients. Many of these patients require higher staffing levels and have been admitted with restraints and significant medication challenges.

  7. The length of stay has increased about two weeks in the last three and a half months for long-haul COVID-19 patients, Mr. Prister said.

  8. Patients are less likely to move to a skilled nursing facility because there is a lack of bed space. This creates a jam in patient flow and doesn't allow for an opening for new patients from the ICU.

  9. Mr. Prister said the role of long-term hospitals has changed in the last few years. There is an agenda, he said, to affirm long-term hospitals are instrumental in the management of COVID-19 patients.

  10. Mr. Prister said that the pandemic has brought on new opportunities for long-term hospitals to identify what their role is in the next pandemic and their role in post-acute care moving forward.

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