Long Term acute care facilities?

[micron]

Wasn't sure where to post this question since it's not specifically about dialysis, so I'll try here.

Anyone have experience with the Select Special Medical Facilities for Acute Long-Term Care?  Specifically the Durham, NC one but I'll take any feedback.  They are a national, for profit operation.  We've been in hospital ICU for 3 weeks recovering from a number of infections and respiratory distress.  Yesterday a case worker I'd never met came in and wants us to meet with this facility for his continued recovery.  I'm suspicious of their motivations (I think they just want the ICU bed freed up) and less then impressed with how they approached us about it. 

Thanks for any information or thoughts on Hospital ICU vs. a specialized facility.

[iolaire]

When I last was in the hospital my bed was within hearing distance of the social workers who deal with stuff like that.  It was very clear they were trying to move the Medicaid patients down the line and out of the hospital.  There was an upcoming snow storm and they were trying to get some old woman flown out of state to some sort of facility that may have been closer to her family.  Given the storm was likely to affect air travel it really seemed like they were pushing things along when it would have been prudent to wait.  But I'm sure they will only be paid for X days, and for me under insurance I would generate revenue for 7 days, therefore there was not rush to setup my dialysis chair at my center so I could get out of the hospital....

As a more positive view my grandmother was moved to an out of hospital care facility as she recovered and after a bit was able to move back into the retirement home she lived in with my grandfather.  I think that type of transition might be normal.

[micron]

Thanks, some research indicates that maximum medicare payouts occur at 20-24 days.  We've been here 21 days and they are pretty hot to have us look at this place asap.  I'm putting it off until my family can arrive as backup.  The typical stay at that facility is also 21 days, so I'm pretty sure I know what has prompted this.  Our current ICU usually only has short term patients, now that he's stable he's not as useful for teaching or extra procedure income.

[Rerun]

Medicare only pays for a certain number of days and if you are not showing improvement they move you to a Rehab place. 

[micron]

he is showing consistent improvement.

[PrimeTimer]

After being in ICU a couple weeks, my mother was offered to be moved to a long term care facility for rehab and until she got better. She had really weakened while in the hospital. I believe she would have received more one-on-one care there but she refused. She was stubborn but also because she had stopped taking her meds, all her levels were out of whack and so she was unable to think clearly. (That's why she ended up in the ICU in the first place). But at her insistence (and when I wasn't there), they released her. Couple weeks later she passed away. I wished she had at least given the long term care facility a try. I think it would have been less stressful on her than being in ICU.     

[cattlekid]

My dad will be heading to a rehab facility by the end of this week.  He's been having a rough year and he took a turn for the worse about two weeks ago.  He filled with fluid which compromised his liver function.  This is a man who never had any kidney issues in the past, but had an aortic heart valve replacement 20 years ago.  Now his liver is compromised due to a leaky tricuspid heart valve, which is causing mental confusion due to the increased ammonia.  Then his kidneys are all wonky because he came into the hospital with 50 extra pounds of fluid onboard. 

They've been able to reduce the fluid load with a combination of lasix and some dialysis treatments with an IJ catheter.  The liver function has been restored with some particularly nasty meds.  So now it's a matter of figuring out how to deal with the tricuspid heart valve.  Per his cardiologist, no one gets surgery for this, especially at age 73. 

I am thankful that I was able to fly halfway across the country and be there this past week when he had his cath placed and started dialysis.  I am really hoping that he is well enough to get out of the hospital and into the rehab by the end of the week. He needs to be in a facility where they can work specifically on getting him well enough to get home more permanently.