For Case Managers

Making Your Job a Bit Easier

At Emory Long-Term Acute Care, we understand that hospital case managers are busy people who process mounds of paperwork in the course of a day’s work. Our goal is to simplify your workload by providing the essential information you need to refer patients quickly and painlessly and make the process as hassle-free as possible.

If you have a patient whom you believe is an appropriate candidate for the LTAC level of care, you can refer him/her via one of the following convenient ways:

  • By phone at 404-501-6226
  • By fax at 404-501-6334
  • Online via Allscripts Referral system (participating healthcare facilities only)

A member of our staff will perform an assessment at no charge and help you determine if your patient meets our admissions criteria. The assessment can be conducted at an acute-care hospital, in a nursing home, in the physician’s office or at an outpatient clinic.  To schedule an assessment, call 404-501-6226.

Referral Triggers

Any ONE of the following may trigger a referral to LTAC after a five-day acute care LOS:

  • Multi-system disease processes – e.g., diabetes, heart failure
  • Frequent change in condition – e.g., increasing or decreasing oxygen saturation, diuretic needs, fluid balance
  • Frequent medication changes – e.g., cardiac meds, repeated IV bolus of Mg or KCL
  • Positive blood or fluid cultures (CSF, sputum)
  • Patients who are positive for osteomyelitis
  • TPN patients with ileus or swallowing problems (need for speech therapy, nutritional analysis, frequent labs)
  • Obese patients with poor respiratory status (hypoventilation) or who need CPAP or BiPap (sleep apnea)
  • Surgical patients with post-operative complications (ileus, respiratory instability, pain control problems, wound infection)
  • Orthopedic patients with complications (MI, diabetic control)
  • Complicated diagnosis – e.g., new CVA with old head injury, multiple pathways
  • Fragile medical conditions – e.g., respiratory problems plus new MI, COPD, or CHF plus pneumonia
  • Mechanical ventilation – invasive or non-invasive

Any TWO of the following may trigger referral to LTAC after a five-day acute care LOS:

  • Recent stay in ICU or step-down unit
  • High oxygen requirements (>5 liters/min)
  • Debrided wound
  • Complex wound processes – e.g., lymphedema, cellulitis
  • Infected wounds
  • Wounds requiring whirlpool treatment or pulse lavage
  • New tracheostomy
  • Patients requiring frequent pain management (IV or pump)
  • Patients requiring frequent physician monitoring (daily vs. weekly)
  • Patients with frequent hospital admissions
  • Patients with reported downward course at home over the past several months
  • Patients who are NPO for a lengthy time (>7-10 days)
  • Nutritional issues – e.g., decreased albumin, decreased protein, underweight, obese, cachexic
  • Multiple wounds
  • Nursing home patients with need for complex management
  • Patients with evidence of deconditioning

Inappropriate Candidates for Referral:

  • Patients refusing to participate in therapy
  • Patients with end-stage disease – e.g., extensive cardiomyopathy (EF<20 percent), cancer with metastasis
  • Patients with mental health issues
  • Simple disease processes with short treatment course
  • Patients without LTAC reimbursement benefits