I work in an LTAC and I'd prefer if the specialists were in-house! The attendings still order consults all the time, only it's more complex to get the paperwork to them. Most specialists come 1-5 days a week depending on who they are and how many they have. I still collaborate with a rehab doctor, a hospitalist, PT/OT/Speech, Respiratory, the CNA, Case Manager and Therapeutic Recreation. Once a week we have a team meeting on each patient where we discuss their progress, barriers to discharge and goals. We have in-house radiology during the day and occasionally in off hours. Other advanced imaging is done at area hospitals, and all labs are sent out to an outside lab (which stinks IMO!)
Admissions and discharges are done by the RN, either the charge nurse or the primary nurse.