Long term acute care facilities fill the gap between hospital and nursing home skilled care. These may be stand alone hospitals or affiliated with a hospital. The senior is too sick to be discharged to a nursing home for rehabilitation so has an extended stay for intensive therapy at the LTAC. The rehabilitation services are coordinated by a physical medicine and rehabilitation physician and include skilled services from nursing, physical, occupational and speech therapy as needed by the patient. The senior may transfer to a nursing home for additional rehabilitation, transfer home for more rehabilitation therapy or be stable for home discharge without additional therapy. Patients with significant infections, wounds or long term ventilator use may be candidates for the LTCA.