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A Complete Guide

Table of Contents

What does LTACH mean?

LTACH stands for Long-Term Acute Care Hospital. You may also see it written as LTCH, which would stand for Long-Term Care Hospital. LTACHs can be stand-alone buildings, or they can reside within a traditional acute care hospital.

LTACHs usually receive patients directly from an intensive care unit (ICU) of a hospital.

What’s the difference between LTACH and Long-Term Care (LTC)?

Long-Term Care (LTC) facilities generally have more of residential feel. For example, LTC websites may refer to rooms as spacious/newly renovated apartments and focus on community living, activities, and other amenities. LTACHs will look and feel like a traditional hospital, focusing primarily on clinical care and rehab. The goal of LTACHs is to help stabilize patients to their baseline of health so that they can return to their home and function independently.

In LTC, residents are seen by a physician less frequently, sometimes only once a month or once every 60 days. In an LTACH, patients are seen daily by a physician or sub-specialist due to high acuity levels.


In most cases, LTC buildings (skilled nursing, assisted living, memory care) will have only one Registered Nurse (RN) on-site to oversee the direct care team (made up of Licensed Practical Nurses and Certified Nursing Assistants), whereas most of the staff work in an LTACH setting are RNs that specialize in working with critically ill patients. Nurses administer medication, monitor patients, record vital signs. and provide personalized treatment plans in both settings. However, LTACH nurses are more like nurses who work in critical care units in a hospital, such as Med-Surg or Step-Down. ICU nurses will have a lower ratio (typically 1:2) whereas Med-Surg ratios are more similar to LTACHs, with a ratio of 1:4, 1:5 or 1:6.


Certified Nursing Assistants (CNAs) work under the direction of a nurse supervisor in LTACH and LTC settings. In both instances, CNAs are responsible for direct patient care, such assisting with Activities of Daily Living (ADLs) which includes dressing, bathing, feeding, and mobility. CNAs must be able to lift and carry a patient’s weight to assist with walking and turning them in bed.

Compliance for CNAs in LTACH includes:

• Basic Life Support (BLS)
• Drug screen
• Two-step TB test
• Relias courses to prove competency
• Ability to move/transfer/reposition patients who are on ventilators or trachs

In LTC, CNAs may not be required to have BLS or a drug screening – it depends on the facility’s preference. However, since LTACH is considered a hospital/acute care setting, CNAs in LTACHs will always be required to have additional compliance completed.

How much experience do I need to work in LTACH?

Due to the acuity levels of patients in an LTACH, most clients required at least two years of nursing experience. However, having nursing experience in LTACH settings may not be required. Clinical experience in a progressive care unit, Med Surg/Tele, or intermediate care is sufficient for an LTACH setting.

What are the responsibilities of an LTACH Nurse?

  • Recording vital signs
  • Administering medication
  • Assisting physicians
  • Providing specialized treatment for chronic conditions
  • Monitoring ventilators and drips
  • Treating/dressing wounds

What clinical skills are needed for LTACH?

  • Experience with tracheostomies (trachs) and ventilators (vents)
  • Wound care
  • Basic Life Support (BLS) provided by the American Heart Association (AHA)
  • Advanced Cardiovascular Life Support (ACLS) provided by the American Heart Association (AHA)

LTACH Specialties

Is LTACH the same as working in Med-Surg?

LTACH is similar to a Step-Down unit. LTACH patients may require ventilator usage and weaning, respiratory care, IV medication or transfusions, complex wound treatment, and/or ongoing dialysis. LTACH patients differ from Med-Surg patients as they typically have not recently undergone a surgical procedure.

Med-Surg nurses treat the following conditions: traumatic brain injury (TBI), hip/knee replacements, sepsis, diabetes, and injuries from falls. Med-Surg experience would be a plus if a nurse is wanting to switch to an LTACH setting because M/S nurses are experienced in treating with patients who have medium to high acuity levels and require extensive wound care, tracheostomies, IVs, feeding tubes, and oxygen tanks.

Are there LTACH travel nursing jobs?

Yes! Many staffing agencies have travel contracts available for LTACH RNs. If you choose to work with LeaderStat, we have LTACH contracts nationwide in the highly sought-after hot spots. Interested in country music? Let’s send you to Nashville, Tennessee where you can spend your free time dancing at your favorite country bar. Do you like mountain views and cooler weather? Let’s send you to Colorado where you can hit the slopes year-round.

View a complete list of LeaderStat LTACH travel nurse jobs.

When searching for LTACH jobs, the job title may vary. Job titles could look like any of the following:

  • LTAC Travel Nurse
  • Long-Term Acute Care Registered Nurse
  • LTAC Nurse

What do Long-Term Acute Care Travel Nurses get paid?

LTACH RN-Salary-1
Salaries for LTACH travel nurses vary based on city, state, time of year, and staffing firm. According to ZipRecruiter, LTACH nurses make an average salary of $88,900 per year, which breaks down to about $43/hour. Keep in mind that travel contracts will also include an untaxed stipend to cover expenses like housing, meals, and incidentals. A stipend is separate from your taxed hourly rate. Hourly rates will be lower for nurses who are local to the building (they would not be receiving a travel stipend since they wouldn’t be duplicating expenses during their assignment). We define local as living within 50 miles of the assignment location.

What is the patient ratio?

LTACH patient ratios are usually 1:5 or 1:6. This means that each RN is responsible for no more than six patients during their 12-hour shift.

What are the shifts like?

In most cases, we see LTACH staff working 12-hour shifts – days or nights. Nurses in LTACHS can expect to work either 7am-7pm or 7pm-7am, three or four days per week (depending on if they’re scheduled for 36 hours or 48 hours).

What types of patients are in LTACHs?

  • The average patient stay is 25-30 days
  • Many patients are transferred to LTACHs from critical care units
  • Patients may require respiratory therapy, head trauma treatment, and pain management

What are the benefits of working in LTACH?

  • For nurses that were getting burned out by a skilled nursing environment or traditional hospital/acute care, LTACH can be seen as a middle ground. Think of LTACH as “taking a step back” from the high-volume, higher intensity settings.
  • Because most LTACH travel nurse jobs are 8-13 weeks and patient stays are around 30 days, nurses get the rare opportunity to see their patients’ care through from start to finish. It can be extremely rewarding to be present in witnessing every stride and improvement through someone’s recovery.
LeaderStat has a variety of LTACH positions open across the country. Our hot states for LTACH travel nurse jobs tend to be in the Midwest region – Michigan, Ohio, Kentucky, and Pennsylvania. To view a complete list of LTACH travel contracts, check out our Job Board.


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