LTACH is exactly what you describe. Acute care patients who need longer than their insurance will allow in a traditional hospital. Many of these do have limited therapy available for patients. Skilled Nursing/Subacute Rehab is a rehabilitation unit in the same building as a skilled nursing facility - patients typically get about an hour of therapy a day. Patients of any age can be sent there. Some may need continuing therapy, but no longer require three hours a day, which is what they'll receive in Acute rehab. Some will go home, some will stay at the nursing facility for life.
Acute Rehab patients receive three hours of therapy, six days a week. They also still have ongoing medical needs that have to be managed and their medical status can change quickly. You get a broad range of patient populations in all of those settings, but if you're looking for intense experience, at an LTACH you'll see PICCs, PEGs, VENTS, TRACHS, the ENTIRE line of medical diagnoses.
In the acute rehab I just left, we had strokes, amps, trachs, LVADs, spinal cord injuries, brain injuries, MS, Parkinson's.. we literally saw it all. Acute rehab patients require a LOT of physical assistance. You'll be transferring patients who require assistance from two people for everything they do, some will need a hoyer or other device, some will need a slideboard. Your main focus will be time management (critical skill!) because your number one priority after medical needs, is ensuring your patients are ready for rehab on time. Your day will revolve around your therapy schedule. You have to ensure your assessment, AM meds, toileting, morning cares and meals are managed and that the patient has enough time to eat, rest, visit, pain managed and that the doctors are aware of any needs the patient needs addressed. It is 100% about time management. That's day shift. PM shift, you're still managing the schedule, meals, etc. and you're also getting the patient in bed for the night. If your facility has 3 shifts, NOCs of course manages the patient's needs during the night, pain management, sleep needs, toileting and they also have an important morning role with helping ensure patients are ready for breakfast and therapy if they have an early start. Labs are usually drawn in the early morning as well. So, as you can see, every shift has an essential role that is affected by the therapy schedule.
Day and PM shifts interact with different disciplines frequently throughout the day. Teamwork is a must.
There are also additional Medicare requirements that have to be met and the nurses play a big part in both of those. There are team conferences every week that the nurse has to be at. There are also scoring systems that the nurses have to know and document on to track the patient's progress.