Long Term Care Hospitals in the Medicare Data

Purpose

The purpose of this article is to define a Long-Term Care Hospital (LTCH) and to identify the files that contain claims submitted by a LTCH.
Current Version Date:
06/29/2017
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Definition of a Long Term Care Hospital (LTCH)

A LTCH is “…’a hospital which has an average inpatient length of stay (as determined by the Secretary of Health and Human Services)) of greater than 25 days.’”[i] A LTCH is not the same as a nursing home. Also, according to a Medpac congressional report[ii], “The Congress and the Secretary should define long-term care hospitals by facility and patient criteria that ensure that patients admitted to these facilities are medically complex and have a good chance of improvement."

Identifying Long-Term Care Hospitals in the Medicare Data

Several Medicare files contain LTCH stays or claims including:

  • MedPAR Research Identifiable File (RIF) 
  • MEDPAR Limited Data Set (LDS) - Hospital (National)
  • Long-Term Care Hospital (LTCH) PPS Expanded Modified MedPAR LDS
  • Inpatient RIF and
  • Inpatient LDS

The Medicare Provider Number (PRVDRNUM in MedPAR or PROVIDER in Inpatient) variable identifies LTCH stays or claims. The last four numbers of the LTCH Medicare Provider Number will have numbers between 2000-2299. The LTCH PPS Expanded Modified MedPAR LDS is a subset of the MedPAR LDS file and only contains LTCH stays.

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Article Information

Author:
Faith Asper, MHS, CIPP/G
Level:
Introduction
Topic:
Data Files or Variables
Program:
Medicare
Category:
Medicare Fee-For-Service Claims
Disclaimer:
The process and materials mentioned as part of this KnowledgeBase article are current, as of the publication date on the article, to the best of our knowledge. The examples provided are correct in the aggregate but may not apply to every subgroup or circumstance that a researcher may wish to study. It is up to the researcher to conduct analysis and confirm that the patterns described in this KnowledgeBase article apply to his/her particular study. If your research findings appear to contradict the advice provided, please contact ResDAC at resdac@umn.edu.