Long-term acute care hospital (LTACH) and rehabilitation
LTACH and rehabilitation records that hold up
Lexcura Summit reads your patient records the way surveyors, auditors and plaintiff's attorneys do, then shows your leadership what holds up and what to fix first, hospital by hospital.
Why it matters
Most citations, payment denials and lawsuits don't start with bad care. They start with a record that doesn't prove the care was right. In a long-term acute care hospital (LTACH) and inpatient rehabilitation hospitals, stays are long, patients are complex and the chart is written by many hands. These are the gaps we see most often:
Ventilator weaning
Daily notes that don't show where the patient stands in weaning, or settings changed without a documented reason.
Skin integrity
Pressure injuries first charted days after they began, or turning and skin checks the record doesn't show.
Change in condition
Early signs of sepsis, infection or decline noted by one discipline without a timely response from another.
Rehabilitation care
A preadmission screening and plan of care that don't match what the team did, therapy minutes that don't add up, or weekly team conference notes copied forward.
Falls and transfers
Falls, and transfers back to acute care, without a clear documented sequence of what happened and why.
How we review
Every review follows The Lexcura Clinical Intelligence Modelâ„¢ through seven pillars, in order, so nothing in the record is skipped or read out of context.
- 01
Record Integrity
Is the record complete, timely, signed and consistent across disciplines?
- 02
Baseline
What was the patient's condition on admission?
- 03
Imaging Analysis
What imaging and other recorded studies show, where they apply.
- 04
Timeline Reconstruction
When the patient changed, how quickly did the team notice, notify and act?
- 05
Standard of Care
Did the care meet what was expected for this patient?
- 06
Regulatory and Compliance Overlay
Does the record meet federal and state requirements, accreditation standards and your own policies?
- 07
Causation Mapping
Which gaps actually connect to an outcome, and which don't?
Services and pricing
The base price is paid in full upfront. Records over the included pages are $350 per additional 100 pages, invoiced separately and paid before work begins.
- Leadership Briefing45 minutes on Zoom on what an attorney or auditor sees in a long-term acute care hospital (LTACH) or rehabilitation hospital record.No costBook a time
- Documentation In-ServiceA 60-minute session for nurses, therapists and respiratory staff, with handout and certificates; recording available.From $1,950Pay Now
- Chart SnapshotFive patient records from one hospital, with a one-page findings sheet.$2,950Pay Now
- Survey seasonBe Survey ReadyA record-focused readiness review before your next survey or accreditation visit.$4,500 per hospitalPay Now
- Single-Event ReviewOne serious event, such as a fall, a pressure injury or a transfer back to acute care, with a written risk memo.$4,500Pay Now
- Records Request CheckReview of a requested record before it's released, with an exposure summary.$4,500Pay Now
- Policy vs. PracticeFour of your policies compared with 12 patient records, gaps ranked by risk.$5,950Pay Now
- Pilot30 patient records across three hospitals, a written report and a leadership briefing.$15,000Pay Now
Because LTACH and rehabilitation stays are long, charts often run past the included pages. We count pages before work begins and confirm any extra fee with you in writing. Standard turnaround is 30 business days, or 20 with rush delivery. Be Survey Ready is delivered in 30 business days after payment and complete records. Reports go directly to you, with an optional 20-minute call to talk them through.
Compliance and Risk Prevention Retainer
For operators who want ongoing protection, the retainer starts with a 90-day baseline review of every hospital, then runs quarterly. Fees are set per hospital and paid at the start of each quarter, with 10% off when the year is paid upfront.
Essential
$4,000 per hospital, per quarter
- 5 patient records audited per hospital, per quarter
- 1 high-risk event review per hospital, per quarter
- Documentation survey-readiness reviews at list price
- Claim, notice and audit-letter reviews at list price
- 1 company-wide staff training session per quarter
- Quarterly leadership briefing
Comprehensive
$6,000 per hospital, per quarter
- 10 patient records audited per hospital, per quarter
- 2 high-risk event reviews per hospital, per quarter
- 1 documentation survey-readiness review per hospital, per year
- 1 claim, notice or audit-letter review per hospital, per quarter
- 1 staff training session per region per quarter
- Quarterly leadership briefing
Enterprise
$8,500 per hospital, per quarter
- 15 patient records audited per hospital, per quarter
- 3 high-risk event reviews per hospital, per quarter
- 2 documentation survey-readiness reviews per hospital, per year
- 1 claim, notice or audit-letter review per hospital, per quarter
- Staff training at every hospital
- Quarterly leadership briefing, plus monthly check-ins
Allowances are calculated per paid location and pooled across the operator’s covered locations. Records, event reviews and included claim, notice and audit-letter reviews are quarterly allowances; survey-readiness allowances are annual, not quarterly. Unused allowances do not roll over. Work beyond an allowance, and services not included in the tier, are billed at list price and paid before work begins.
Audit-letter reviews look only at what the clinical documentation shows. Lexcura Summit does not provide billing, coding or legal advice.
How an engagement works
- 01
Conflict check: We confirm we're free to work with you, usually within one business day.
- 02
Agreement, BAA and payment: You sign our services agreement and Business Associate Agreement and pay through our secure payment link.
- 03
Secure records transfer: Records come only through our secure portal, never by email.
- 04
Review and delivery: Our analysts work through the seven pillars and deliver a written report directly to you.
Who does the work
Clinical findings are made or verified by clinicians holding an active registered nurse license or a higher clinical license.
Trained analysts, including paralegals, organize records, build timelines and check citations under clinical supervision. They may confirm that a date, medication or citation matches the source page; standard-of-care, causation and other clinical judgments go to a licensed clinical reviewer.
Michelle Carroll, Founder and Chief Clinical Strategist, developed the Model and leads every engagement personally. Her background is in clinical leadership, including four years as Director of Professional Services at Concierge Home Care in Gainesville and service as Division Director of Home Health at Westminster Communities of Florida. She is the author of Clinical Intelligence in Healthcare Risk, Compliance, and Insurance Investigations.
Confidentiality
We run a conflict check before every engagement and never accept matters adverse to a current client. Records stay in our secure, BAA-covered system, seen only by the team assigned to your work.
Start with a conversation
The easiest way to see how we work is a 45-minute leadership briefing for your clinical, quality and compliance leaders, on Zoom.
Or email michelle@lexcurasummit.com