Please help and guide: need PGH area rehab facility + dialysis

[glennmatthew, ADN, RN]

Hello all. Thank you in advance for taking the time to read this and offer any guidance. My fiance' and I are in what seems to be a bad situation pertaining to the care of her mother. Long story short, we are looking for a place (SNF?) where she can receive dialysis as well as trach care. Her mother had an MI and went in for an emergency cath. During this, she required intubation. The process of weaning her from the trach is now prolonged due to paralyzed vocal cords (apparently). She's breathing on her own rather well now, but due to the vocal cord issue, she may need to keep the trach. At least that's what is being conveyed to us. The facility she's in now was to specifically deal with getting rid of the ventilator assistance and trach. Now that it seems we're at an impasse, they are ready to ship her out to get PT and get her back on her feet. The only problem is that we're told the closest place to offer dialysis & trach care is 1.5 hours away. We're in Pgh.

I've been trying to locate resources on the net with little luck. Since it's Sat, I can't call to speak with the case manager. To top it off, my father-in-law-to-be really has a special way of dealing with individuals (his way or the highway approach to interpersonal communications). So, I've been on this board for some time as a student and now graduate nurse. And I thought I'd throw out a line to see if anyone bites.

Here's some specific ?'s:

1) Am I correct in assuming that if we don't want her to go to the facility they suggested, we can refuse and she can stay where she's at until a bed opens up at a closer facility?

2) Can anyone point me in the direction of searching for rehab facilities that offer dialysis and trach care?

Thank you again for any input.

glennmatthew

[NRSKarenRN, BSN, RN]

appears fiance's mother is in an ltac: long term assisted care hospital. in order to move to a rehab facility, she needs to be able to tolerate 3hrs a day of therapy per rehab facility regs; most patients who also need dialysis are unable to tolerate that much rehab in same day as dialysis.

often best solution is a subacute rehab unit in a skilled nursing facility (snf)--provides 1-2hrs/day rehab services. it's rare in pa to have a rehab/subacutefailicty that can provide dialysis onsite patients needing dialysis are transported 3 days/week to outpt dialysis center. not all snf facilites have staff skilled in trach care or have respiratory therapy support.

the ltac case manger or social work staff should provide you with a list of facilites that can accommidate her needs that you can visit + select. as soon as ltac goals are met, facility will no longer receive payment for care + they have the right to transfer her to next level of care - any appropriate facility that has an open bed.

since case mgmt/sw staff on the weekend, please followup monday to obtain list.

i'm only aware of philly facilities; i looked in my agencies discharge planning software and came up these names of pgh area facilitesto check out:

the commons at squirrel hill skilled nursing & rehabilitation

baldwin health center/bhc/communicare family of companies

manorcare health services - greentree/hcr manor care

sky vue terrace/hcr manor care

(manor care only company i'm familar; quality varies by location)

see: pennsylvania skilled nursing home facilities - view all skilled ...

wishing better days ahead for all.

[CoffeeRTC, BSN, RN]

Can you PM me..I might be able to suggest a few. I don't really know of any that do dialysis in house. We send out dialysis pts out for HD. Weve done PD in house and I think other facilties will do it. All of the skilled care places should take trachs.

What part of PGH are you looking for? North, South, East, West?

Extendicare has a few facilities in the area. There are the Manor care ones, UPMC ones and other local ones.

As far as the hospital kicking her out....I've seen it happen. Family wasn't aware until the last minute. It happens.