Each year, over 70,000 people with serious illnesses receive care in long-term acute care hospitals (LTACHs). Many are older, medically underserved, and have multiple health issues. Most aren’t on ventilators but need intensive treatments like wound care, IV therapy, or dialysis, and the average survival rate is just 8 months. Although palliative care could greatly benefit these patients, only about one-third of LTACHs offer it. Little is known about how these programs are structured, who provides the care, or why most LTACHs don’t have them.

This article examines how palliative care programs in LTACHs are structured and staffed, compares LTACHs that have these programs to those that do not, and explores leaders’ views on the challenges and barriers to starting palliative care services.

Don’t have access to the full text? Email Anil Makam, anil.makam@ucsf.edu, to request a pdf version.