What does the LTCH PPS classify patients based on?

The Long-Term Care Hospital (LTCH) Prospective Payment System (PPS) classifies patients primarily based on Long-Term Care Diagnosis-Related Groups (DRGs). This classification system takes into account the principal diagnosis, as well as secondary diagnoses and procedures performed during the hospital stay. By categorizing patients in this way, the LTCH PPS aims to promote more equitable payment rates and to facilitate the planning of care tailored to the specific needs of patients who require extended hospital stays.

The use of diagnosis-related groups is significant because these groups are designed to reflect the complexity of the care provided and the resources used during the patient's treatment. This methodology ensures that payment reflects the costs associated with the specific conditions treated, enabling hospitals to be reimbursed appropriately based on the severity and type of care required by patients.

Understanding this classification is crucial for comprehension of how LTCHs structure their billing and reimbursement processes, as it directly ties into the services provided and the financial sustainability of long-term care facilities.