Many critically ill patients survive their episode of acute illness but subsequently develop persistent respiratory failure necessitating prolonged mechanical ventilation.1 These patients are often transferred to long-term acute care hospitals (LTACHs)—facilities that specialize in the care of patients with persistent respiratory failure and other complex conditions.2 Driven by an aging population, increased survival following critical illness, and hospital reimbursement models that incentivize early discharge, use of LTACHs has substantially increased in recent years.3 Currently 412 LTACHs are in operation in the United States. These hospitals admit more than 130 000 patients annually and account for more than $5 billion in Medicare expenditures each year.4
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