Most families have never suffered through a loved one experiencing prolonged critical illness and respiratory failure (defined as ventilator dependence for weeks, usually with a tracheostomy). But each year, more do. An estimated 400,000 people currently live with chronic critical illness in more than 400 U.S. long-term acute care hospitals (LTACHs) — a population that has more than tripled in the past 15 years in one of the fastest-growing segments in health care. Sadly, most LTACH patients never leave alive, except to return to traditional hospitals for more intensive care. About half die within a year, and many of those who survive remain permanently dependent on a ventilator. Only a fraction ever walk again, and even fewer regain functional independence.

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