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My mom has been at Select Hospital for 2 weeks now. On a vent for 4 after bypass surgery. I am not happy with Select at all. Does anyone have any experience with Select of any suggestions?
 
Posts: 1 | Registered: October 29, 2011Reply With QuoteReport This Post
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I am an advocate for good Long Term Acute Hospitals. I have been on staff at several good ones. I have been a regional trainer for one of the largest LTAC comapnies out there and what I have seen is that each facility is totally different. Most of them are part of a large chain and the home office sets many of the parameters of operation and often hamstring the staff in the individual facilities, but I have seen cases where a motivated team of people can overcome the burdens of management that cause lapses in quality and provide good care. The management of these companies is at a loss as to why the lapses occur. They just see it as running a business and getting the most for shareholders. Health care facilities are not like any other business, lives are at stake. I try to say nothing negative about anyone here, but you may want to look into another LTACH for your mother. A competitor can not be stopped, if it is your wish, from coming in and evaluating your mom. You can ask at other LTACs if there are any. Otherwise keep someone present as much as possible who is an independent advocate for you mom and insist on reports of progress daily. You should be able to request a family meeting and meet with the doc nurses and therapists and get updated on her progress. I have encountered recently LTAC hospitals that staff their RT department based on the number of ventilators running in the building, not the number of procedures (best) or even the number of patients in the facility (not so good but better than on the number of vents) this puts the people caring for the vent patients RT in a compromised position. Do they really want to wean anyone when they will have less staffing if they successfully get every vent patient off of their ventilator? I found some stories on the company you mention. They are not the specific facility, and events and situations described are not limited to only that company, but management that tries to squeeze every dollar from care for shareholders at the expense of quality will result in similar. Good LTACHs are a good investment of HC dollars, bad ones are hell holes. I am not sure Medicare or JCAHO is able to totally determine the differences. I have seen what I knew were poor facilities pass without deficiencies.
http://www.nytimes.com/2010/02...alty+Hospital&st=nyt
http://www.nytimes.com/2010/02...alty+Hospital&st=nyt
http://www.nytimes.com/2010/03...alty+Hospital&st=nyt

For anyone looking to move a vent patient to a LTAC hospital, my advice is tour the facility. You should meet the RT Director, the Rehab Director, the Nursing Director. Compare claimed staffing ratios for nursing and RT. Compare wean rates (closer to 90% the better), and time to wean (around or less than 14 days is OK). Does the place smell? Are you greeted in a friendly manner by most you see or encounter? Are patients mobilized as early as possible, even while still on the vent? Is there 24/7 physician in house?

I hope you mother rallies and does well.

God bless.
 
Posts: 143 | Location: Fort Worth Tx | Registered: January 27, 2006Reply With QuoteReport This Post
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