Hospital Stakeholders Release Long-Term Acute Care Hospital Reform Policy Principles

New principles created to guide Congress as it considers policy reforms to better support America's LTCHs

WASHINGTON (March 30, 2026) - A group of hospital stakeholders, including the American Hospital Association, the Federation of American Hospitals, National Association of Long Term Hospitals and Coalition of Long-Term Acute-Care Hospitals, today announced the release of Long-Term Acute Care Hospital (LTCH) Reform Policy Principles. The principles are designed to guide and inform Congress as momentum builds to provide relief to LTCHs and the patients they serve. As longer-term reforms are developed, the groups urge Congress to act swiftly to enact legislation that stabilizes the LTCH sector. Without timely action, additional LTCHs are likely to close, further limiting access to the specialized care that LTCHs provide to chronically and critically ill patients.

LTCHs play a unique role in the care continuum by providing care for the most severely ill Medicare patients who require extended hospitalization. These specialized hospitals offer a uniquely intensive level of care that is not generally available in other post-acute care settings. However, the current policy environment presents challenges to patients trying to access care and negatively impacts the financial stability of the nation's LTCHs.

The comprehensive set of policy principles address current challenges and offer sustainable solutions to protect and strengthen the delivery of care in the LTCH sector, including:

• Ensure access for certain high-acuity beneficiaries by expanding payment criteria
• Improve accuracy of the LTCH Medicare Prospective Payment System (PPS)
• Consider changing the 25-day average length of stay (ALOS) requirement
• Restructure the LTCH outlier system
• Expand rural access to LTCHs
• Rein in harmful Medicare Advantage (MA) practices

Read the full set of policy principles.

Media Contacts

American Hospital Association, Sharon Cohen, [email protected] of American Hospitals, Hannah Hurley, [email protected]

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About the American Hospital Association

The American Hospital Association (AHA) is a not-for-profit association of health care provider organizations and individuals that advocates on behalf of our nearly 5,000 member hospitals, health systems and other health care organizations, clinician partners and health care leaders. For more information visit https://www.aha.org.

About the Federation of American Hospitals

The Federation of American Hospitals (FAH) represents the country's leading tax-paying hospitals and health care systems to advance public policy, ensuring patients & communities have access to high-quality & affordable 24/7 care. For more information visit https://www.fah.org.

About the Coalition of Long-Term Acute-Care Hospitals

The Coalition of Long-Term Acute-Care Hospitals represents the shared federal policy interests of many of the nation's key providers of long-term acute-care hospital (LTCH) services.

About the National Association of Long Term Hospitals

NALTH is the premier association representing long term acute care hospitals (LTCHs) and associated professional staff committed to advancing the health, well-being and quality of care for medically complex patients who require prolonged hospital stays. For more information visit https://www.nalth.com.