What Is Sub-Acute Care?

Sub-acute care is a level of healthcare designed for patients who require more intensive care than what is typically provided in a skilled nursing facility but less intensive than the care given in an acute hospital setting.

Also known as transitional care or intermediate care, sub-acute care serves as a critical bridge for patients transitioning from the hospital to their home or another long-term care environment, ensuring continuity in patient care. Here, we delve into what is sub acute care, including its significance, settings, patient eligibility, and the challenges and benefits of this care level.

Understanding sub-acute care

This area of care is essential in managing patients who are too well to remain hospitalized but still too ill or dependent to return home without significant medical support. It focuses on patients with complex medical conditions, providing therapies, treatments, and monitoring that are not available in a home setting.

Key features of sub-acute care

Comprehensive medical and nursing care

Patients receive around-the-clock care from a team of healthcare professionals, including physicians, nurses, physical therapists, social workers, and more.
The care provided includes wound management, intravenous therapy, respiratory therapy, cardiac monitoring, and rehabilitation services.

Individualized care plans

Care plans are tailored to meet each patient’s specific needs, considering their medical conditions, recovery goals, and overall health status.
Multidisciplinary teams develop and regularly update these plans based on ongoing assessments and patient progress.

Focus on rehabilitation

Rehabilitation is a core component, aiming to restore patients' functional abilities and promote independence.
Services include physical therapy for mobility, occupational therapy for assistance with activities of daily living (ADL) like dressing and bathing, and speech therapy for communication or patients with difficulties swallowing.

Short-term stay

Sub-acute care is generally intended for short-term stays, typically ranging from a few days to several weeks, depending on the patient's condition and recovery progress.

Settings for sub-acute care

Sub-acute care can be provided in various settings, each equipped to offer specialized services tailored to patients' needs.

Sub-acute care units in hospitals

Many hospitals have dedicated sub-acute care units for patients transitioning out of acute care.
These units are designed to provide intensive medical and rehabilitation services.

Skilled nursing facilities (SNFs)

Some skilled nursing facilities have sub-acute care units offering a higher level of medical care and rehabilitation services than typical nursing home care.
These facilities are often chosen for their proximity to patients' homes and their capacity to provide extended recovery support.

Inpatient rehabilitation facilities

These specialized facilities focus on intensive rehabilitation for patients recovering from major surgeries, strokes, or severe injuries.
They offer a structured environment with a strong emphasis on restoring functional abilities and independence.

Long-term care hospitals (LTCHs)

LTCHs provide care for patients who need extended medical treatment and rehabilitation.
They cater to patients with chronic, complex medical conditions that require prolonged care, such as severe respiratory issues or multiple organ failure.

Patient eligibility for sub-acute care

Determining eligibility for sub-acute care involves evaluating the patient’s medical needs, recovery potential, and overall health status. Common conditions that may necessitate sub-acute care include:

Post-surgical recovery

Patients recovering from major surgeries, such as joint replacements or organ transplants, often require sub-acute care for rehabilitation and monitoring.

Neurological conditions

Stroke patients, those with traumatic brain injuries, or individuals with progressive neurological disorders benefit from the comprehensive rehabilitation services offered in sub-acute care settings.

Chronic illness management

Patients with chronic conditions, such as chronic obstructive pulmonary disease (COPD) or diabetes, may need sub-acute care to stabilize their health and manage complications.

Complex wound care

Individuals with severe wounds, pressure ulcers, or post-surgical wounds that require advanced wound care and monitoring are suitable candidates for sub-acute care.

Respiratory therapy

Patients needing respiratory support, such as those with tracheostomies or ventilator dependence, can receive specialized respiratory therapy and weaning in sub-acute care facilities.

Palliative and end-of-life care

Sub-acute care can also cater to patients needing palliative care to manage pain and symptoms associated with serious health conditions, improving their quality of life during the end stages.

Healthcare professionals in sub-acute care

A multidisciplinary team approach is crucial in sub-acute care, ensuring comprehensive and coordinated care for patients. Key team members include:

Physicians:

Oversee patient care, develop treatment plans, and coordinate with specialists to address complex medical needs.
Conduct regular assessments and adjust care plans based on patient progress.

Registered nurses (RNs) and licensed practical nurses (LPNs):

Provide direct patient care, administer medications, monitor vital signs, and assist with ADLs.
Educate patients and families about managing health conditions and recovery processes.

Physical therapists (PTs):

Develop and implement exercise and mobility programs to improve patients’ physical function and strength.
Use various techniques and equipment to enhance recovery and independence.

Occupational therapists (OTs):

Help patients regain skills needed for ADLs, such as dressing, bathing, and eating.
Provide adaptive equipment and training to improve patients’ independence and safety.

Speech-language pathologists (SLPs):

Address communication and swallowing disorders through targeted therapies and exercises.
Develop personalized treatment plans to enhance speech and swallowing functions.

Social workers:

Assist patients and families in navigating all aspects of the healthcare system, including discharge planning and community resources.
Provide emotional support and counseling to address the psychosocial aspects of recovery.

Case managers:

Coordinate care transitions, ensuring continuity and comprehensiveness in patient care.
Work with insurance companies to manage coverage and facilitate necessary services.

Benefits of sub-acute care

Sub-acute care offers numerous benefits for patients transitioning from the hospital to their home or other long-term care settings:

Enhanced recovery:

Comprehensive rehabilitation and medical services support faster and more effective recovery, reducing the likelihood of hospital readmissions.

Improved patient outcomes:

Individualized care plans and multidisciplinary team approaches ensure that patients receive holistic and coordinated care, leading to better health outcomes.

Continuity of care:

Sub-acute care bridges the gap between acute hospital care and home or long-term care, ensuring seamless transitions and ongoing support.

Patient and family education:

Education on managing health conditions, medication management, and lifestyle modifications empowers patients and families to take an active role in recovery.

Cost-effectiveness:

Sub-acute care is often more affordable than prolonged hospital stays, providing high-quality care in a less intensive setting.

Challenges of sub-acute care

Despite its many benefits, sub-acute care also presents certain challenges:

Patient complexity:

Managing patients with complex medical conditions and diverse needs requires highly skilled and coordinated care teams.
Ensuring all aspects of a patient's health are addressed can be challenging, particularly in cases involving multiple comorbidities.

Resource limitations:

Sub-acute care facilities may have limited access to specialized medical equipment or advanced treatments available in acute hospital settings.
Balancing resource allocation and patient needs can be challenging, particularly in under-resourced areas.

Reimbursement and coverage issues:

Navigating insurance coverage and reimbursement for sub-acute care services can be complex and time consuming.
Patients and families may face financial burdens if insurance does not fully cover the costs of care.

Transition management:

Coordinating smooth transitions between care settings requires effective communication and collaboration among healthcare providers.
Ensuring continuity of care during transitions can be challenging, particularly if communication gaps or delays occur.

So, what exactly is sub acute care? Sub-acute care is a vital component of the healthcare continuum, providing essential services for patients transitioning from acute hospital care to home or other long-term care settings.

With a focus on rehabilitation, comprehensive medical care, and patient education, sub-acute care aims to enhance recovery, improve patient outcomes, and ensure continuity of care. Despite the challenges, the benefits of sub-acute care make it a critical resource for patients with complex medical needs, offering a bridge to better health and independence.