ltac
patient on HFNC/bipap support, on IV solumedrol and IV antibiotics Q24, is this patient appropriate for LTAC?
yes
patient s/p abdominal surgery who developed and ileus and post op infection. he is currently on tpn and Iv reglan and Iv antibiotics.
would this patient be ltac appropriate?
yes, this patient has enough on going needs that he would qualify for ltac stay.
does a patient need to be sitter free for 24 hours before we can accommodate a patient.
NO, the more notice the better so we can make sure we have the appropriate staff to accommodate the patients needs, but we can manage patients who need a sitter.
patient will need a veriflo wound vac at discharge...are we able to manage that type of vac at regency?
yes we can manage the veriflo wound vac and have a certified wound care nurse in house that will assist with dressing changes.
a paramount commercial patient will require a 3 day icu stay to be eligible for ltac?
false, commercial payers do not require 3 day icu stay to be ltac eligible. only meidcare and medicare HMO's.
pt s/p TBI on trach collar during day and vent at HS. getting IV anti-seizure meds and on Ativan drip for agitation. ltac appropriate?
yes, we can manage patient and take the patient on the Ativan drip as well as numerous other critical drips.
for a medicare or medicare replacement patient to be able to qualify for ltac stay do they need to have a 3 day stay in an ICU?
they do need a 3 day stay, but does not necessarily have to be in an ICU unit..they just have to be billed as an icu patient, patients admitted on tele and to progressive units have appropriate days. We have the ability to verify billing codes, if there is Ever a patient that you think could benefit from a higher level of care just send the referral and we can verify codes quickly. could make the difference between a positive outcome or a quick readmission if snf cant handle acuity.
if a patient inquires if their dr follows them at regency what is the best response?
you can call me and I can inform you, I can meet with the patient and let them know which of their drs will be following them to Regency. We have a ton of Drs with privileges that cont to care for patients at Regency including Dr simo, Dr pipoly/ruiz, Dr abbas, Dr zeitouni/ahmed, dr flicks group...etc. I can also provide physician list if needed.
patient was tx from hospital up in Michigan and family is from that area and is interested in an ltac closer to home. the family narrows it down to grand rapids select specialty hospital. what is the next step?
referral can be sent to select specialty grand rapids and also to regency. I will be the person who does the assessment and talks to family and patient about transitioning care to grand rapids and will also get family in touch with grand rapids to answer and questions that I may not know answer to. at time of discharge I will still be the contact and can arrange transport time and get report number and fax number for CRF/med rec.
anthem medicare vent patients require 21 consecutive days on vent with at least 3 failed wean attempts.
true, must be consecutive days. if they were on the vent for 17 days and they trial them off vent and they fail and end up going back on vent and getting trach and peg 4 days later the clock resets the moment they are taken off vent:(
at that point we still can submit to insurance and if denied we can still do a p2p and appeal if needed.
IV drug user with endocarditis will need 6 week course of IV vanco? ltac appropriate?
yes
Do commercial insurances need to have a 3 day icu stay?
NO. it is only the medicare and medicare HMO policies.
patient is s/p left foot amputation, no current infection, is getting wet to dry dressing changes bid, and was placed on argatroban drip for new onset a fib.
is this ltac appropriate ?
yes the patient is ltac appropriate and we can manage the argatroban drip.
if you have a question regarding if a patient would be eligible for ltac based on his/her insurance what should you do?
call me..i can tell you over the phone if the patient is eligible based on insurance.
If my patient gets denied by insurance my patient is not eligible for regency?
if the initial auth was denied we have the option for peer to peer, obviously some insurances are more cooperative than others when it comes time for peer to peer, and if the peer to peer is denied we can always do expedited appeal.
patient is 15 days s/p colon resection, he is on dysphagia diet, weak, no iv meds, small wound to coccyx requiring daily dressing changes with foam dressing. ltac appropriate?
NO, patients needs can be managed at a lower level of care.
patient presents with large coccyx wound, ortho debrides wound, places wound vac and patient is on iv antibiotics for infection to wound.
would this patient be ltac appropriate?
yes, having a recent debridment, along with the vac and antibiotics patient would meet criteria.
patient presents with acute on chronic resp failure and goes septic during current stay. has a prolonged Icu stay and eventually gets a trach and peg and is currently on fentanyl and propofol drips.
can this patient be managed at regency?
yes we can manage the patients current acuity and the critical drips at regency.
patient is morbidly obese and weighs 600lbs but could benefit from a higher level of care at dc due to multiple medical problems...can regency manage that population of patients?
yes there are no weight restrictions, obviously some equipment might need to be ordered ahead of time to accommodate but still can manage the larger patient population.
patient has had multiple admissions for exacerbation of resp failure and having recurrent respiratory infections. He is on and off bipap support and is malnourished, his kidney function is elevated above his baseline and he has IV diuretics daily. Is he appropriate for ltac?
yes this patient would meet ltac criteria, we can manage patients on bipap with our ATC respiratory therapists and can monitor his daily labs and IV diuretics
patient presents with chronic wounds which have worsened, she is getting "mist" therapy for her wounds, she is also on IV antibiotics for worsening cellulitis, and is in fluid overload with nephrology managing her electrolytes and daily labs.
Ltac appropriate?
yes. We are doing Mist Therapy now at Regency:)
we can also manager her labs daily and replace electrolytes as needed.
patient presents s/p mva, develops acute resp failure and fails multiple weaning from vent attempts, patient has a trach and peg placed and is on levophed for sepsis and blood pressure control.
is this patient ltac appropriate?
yes, we specialize in vent weaning and can manage almost any critical drip aside from paralytics.
patient s/p hemicolectomy, failed swallow and has NG tube feeds, having pain control issues and is on morpine pca pump.
can we manage this patient?
yes we can manage a PCA pump at Regency and our in house speech therapist can cont to work with patient to return patient to a oral diet.
if patient condition worsens at Regency overnight what do we do?
We have a dr that spends the night...EVERY NIGHT to be there if certain situations arise. We have a CT scanner and radiology onsite if any scans or x rays need to be done. in some situations the patient will need to be sent back to hospital if things arise such as gi bleeds, stroke, etc. But for the most part we can manage many critical situations. Our hospital readmission rate is lower than any of the competitors, and over half as much as the skilled facilities.
How many beds does Regency Hospital have?
We are a 45 bed stand alone hospital. We have 2 separate units in the hospital. We have a "high obs" unit where patients who come on the vent and on critical drips will go to be managed. We also have in house pharmacy, cafeteria, family waiting room, we have in house radiology, we can give blood if needed, in house dialysis, did I mention we are doing "mist therapy" as well:)