Evolution of transitional care settings: past, present, future

Transitional care settings have evolved since the 1980s as Medicare prospective payment has affected acute hospital reimbursement and hospital length of stay. These settings include hospital-based subacute units, typically called transitional care units; subacute care units in freestanding nursing facilities; and long-term care hospitals. This article focuses on these transitional care settings: what they are, how they developed, what reimbursement issues affect these settings, and what is likely to happen next. In the future, advanced practice nurses may not only refer patients to transitional care settings, but also may find them to be sites for practice.