LTAC (Long Term Acute Care) facility?

Bridey · Sep 3, 2007

I am in North Texas, and LTAC hospitals are a "dime a dozen" around here. There's Kindred, Lifecare, Regency, and a whole slew of others.
These places tend to pay very well, offer good benefit packages, and entail plenty of nursing skills. However, the nurses who work at these types of facilities are expected to perform full care on their patients, at least in my area.

My assumption is that you mean they didn't employ CNA's at the places in North Texas, is that correct? At this particular hospital they do employ CNA's. Thank goodness for that. I really think team nursing is the most beneficial for all parties involved... coworkers & patients alike.

From what I have been told, patient/nurse ratio is 4-1 or 5-1 in Med-Surg & Med Tele... and 2-1 in ICU. I guess I'll find out in 15 day or so. I accepted the job offer and will be attending orientation on Sept. 18th. The pay is nowhere near what I made in California, but I'm also not paying what I would in California for a 3 br house. And the benefits package is pretty awesome and starts just 30 days after employment. Pretty awesome.

softstorms · Sep 3, 2007

Hello Bridey Like Commuter, I am familiar with Kindred and LifeCare as they have many facilities around the U.S. Most "nursing homes" have moved past the long term pts. and have acute care units within them. It is a great way to sharpen your skills and learn. I relocated to the south from a hospital position to a LTC facility. I was surprised to see that most "Nursing Facilities" are not just nursing homes now. I also found that most of these facilities are willing to invest in spending more on the employee's education. As the needs of the facility are changing, so will the challenges. Most facilities pay well because they need the type of staff willing to step up to the new needs of the patients. So try it out, I don't think you will be dissapointed.

rizza · Sep 3, 2007

I recently attended a job fair at a local facility (SE Texas) that's called a "free standing LTAC". They're apparently a step down from the hospital and provide care for patients who need care that lasts anywhere from 20-60 days. The acuity level seems to be pretty high (post MI, CABG, CVA, Sepsis, Burns, MRSA/VRE, Chronic Pain, multi-system failure, vent dependent, etc). There's even an 8 bed ICU.
Anyhow, this is a new concept for me. I don't even know that there are facilities like this in California (where I started my nursing career). If there are, I've never heard of them. I used to work on the Skilled Rehab unit of a Long Term Care facility that had patients with similar acuity levels, but this place I attend the job fair at was really nothing like my former job.
This place has a 4-1 ratio in Med-Surg and Med Tele. And in the ICU it's 2-1.
Do you have LTAC's where you live? Has anyone worked at one before?
Just curious because this place offered me a position and I'm seriously considering taking it. It almost sounds too good to be true though... LOL

I did my clinicals in California at a LTAC and there stay was limited to A 30-60day stay. These pt were post CVA, CRF, heart failure, horrilble decubs, MRSA, COPD, g-tubes, aspiration pneumonia with trach's, ventilators, osteomyelitis, and much more. There was a 4 bed ICU and the med surg floor held about 60pts. RT was staffed, wound care nurse on every wens, physical therapist. This facility was intense and alot of work. It would be a great place to get alot of experience.

TheCommuter, BSN, RN · Sep 3, 2007

Most "nursing homes" have moved past the long term pts. and have acute care units within them. It is a great way to sharpen your skills and learn.

This is so very true. I work at a nursing home. However, I work on a short-term rehabilitation unit where the typical patient is discharged home in 2 weeks.

I deal with mostly postsurgical patients who are too deconditioned to go home. These patients are CABGs, knee and hip arthroplasties, thromboembolectomies, hysterectomies, post CVAs, fractures, and so forth. One time I received a gentleman who was badly beaten and robbed, and needed reconditioning. Many of my patients are middle-aged, and wouldn't fit the description of the average nursing home patient.

I regularly give drugs via IVPB and IV push, especially antibiotics. I remove sutures and staples, dress complicated wounds, operate CPM (continuous positive motion) machines, iceman machines, oxygen tanks, concentrators, and PEG tubes. I had been employed on a traditional long term care unit for a year, and I had not been exposed to some of these skills.

kstec, LPN · Sep 5, 2007

I was just reading this thread and thought I would look to see if any of these facilities are around here and not one could be found. There are some a few hours away or out of my state of Illinois but none in the immediate area. I thought if there was one it would be a great place to actually utilize my LPN skills, but I guess it's not in the cards for me yet. Sounds like a neat place to work.

CNAinNeb · Feb 23, 2008

Does anyone know if there are facilities like this around Omaha, NE or Council Bluffs, IA?

BayouLPN · Feb 24, 2008

I am in Louisiana. We have a LTAC facility attached to one of our Hospitals. LC Memorial. While they hire LPNs, you have to have several years experience. Memorial hires LPN's right out of school and is a teaching hospital. So, those interested may transfer before they hire from the outside! I do not see this particular facility advertising for help all that often. While I have not been in the LTAC, I have heard many good things. Lower ratio for one. I think that it is an awesome place to put skills to practice and learn new ones. However, I DO NOT think it is easy. I think you did well because you have alot of experience in assessment and time management. The fact that they were at a job fair could be good or bad. Find out why they are seeking new employees...expanding, had a couple leave for various benign reasons...or was there a mass exodus of employees? Ask around. People will talk. The place as a concept is great. It is the management that will make it worth working for.

suanna · Feb 24, 2008

I'm N.E. Ohio- they are pretty common around here. Hospitals used to be able to lease out an unused floor to an agency that woud open up a LTAC center. The feds have stopped that as of this year- it made too much sense I guess. I've never worked at one but the centers in this area seem like a nightmare. The patient you couldn't handle 1:2 in ICU with multi-system problems is on a floor with 1:5-6 staff to patient ratio. The outcomes at our local LTAC units aren't as rosey as we would like. I pray I can get better or die if I end up in ICU before I run out of approved days. The poor souls that get turffed to a LTCA center seem to be in limbo- to healthy to die to sick to recover! Great place for experience, but it is an experience I would rather never have.

bluegeegoo2, LPN · Feb 24, 2008

Select Specialty Hospitals are like those described above. We have 1 here in S. Indiana. I was there on clinical and LOVED it! Their ratio is 5:1, and they also have a dialysis suite and a small ICU. I think they are nationwide. I plan to try to "get on" there after I have some experience under my belt.

rntofnp2014 · Apr 9, 2010

:nurse: I just recently started working at an LTAC in northern ohio. Aides 1:14 ratio, Nurses 1:3-5 (dep on acuity and census). On a floor at a hospital. Uses hospital systems computer system, does paper charting, uses the OR, lab, dignostics, and medical that the hospital uses. These patients are: trached, vented, pre and post transplant, transplant rejection, pre and post VAD placement, IV sedation and cardiac drips including levo, autonomy (nurses has protocol/standing orders so as to not have to get emergency orders prior to ACLS stuff, common issues, titrating meds, restraints). These patients are 'too sick to live and too healthy to die' as quoted from another allnurses.com member. These patients are on walking a fine line between recovering or not. Procedures done at bedside include broncs, colons, debriedments, flap closures, CVP line placement, PICC line placement, dialysis, tele. Also seen are wounds that are extremely complex, multi system organ failures, neuro, MDROs. The nurses seem to enjoy the place they work for, rave about the boss lady, and seem to genuinely care about the patients and have the time to do it. There are so many tasks in a shift that I'm hoping I won't grow bored.

The pay is sooo great, the benes are better than most, and the NM seems to be totally supportive of the staff and their needs (i.e. ok with splitting up a shift 2/10, 4/8, 6/6 between nurses), and this place has it's own in house 'agency' which staff can sign up to work through and get paid the next day for picking up any hours in increments of 2. The pay for that is a five buck bump, too. Oh, and they will pay you for that shift you picked up yesterday, today, if you want. Vacation time per year to start, 18 12hour days, aka six whole weeks!

Good luck to you at your new job. Keep us posted on how it goes.

lwndrgn · Apr 18, 2010

Hi all, I live in North Texas and will be graduating in August as a LVN. I want to work for one of those LTAC but alot are now not hiring LVNs or want some experience...What would be the best experience for me to get?

didi768 · Oct 16, 2012

Will working at a LTAC such as a Kindred help on my resume if I later want to go into regular hospital nursing later on or does it kind of kill your chances? I Had hosp. exp. years and years ago, but last 10 yrs. has been mainly home care.

Thanks!