Long term acute care hospital (LTACH) - ANSWER• Extended rehab clinically complex pt
• Neuro (TBI, stroke), multiple trauma, ventilator weaning, post total hip/knee
• Located within/outside hospital
Inpatient rehab facility (IRF) - ANSWER• Free standing hospital or specific unit in AC...
DISCHARGE PLANNING CORRECT
100%
Long term acute care hospital (LTACH) - ANSWER• Extended rehab clinically complex pt
• Neuro (TBI, stroke), multiple trauma, ventilator weaning, post total hip/knee
• Located within/outside hospital
Inpatient rehab facility (IRF) - ANSWER• Free standing hospital or specific unit in ACUTE CARE
HOSPITAL
• Treats spinal cord injury, stroke, major trauma, amputation, post transplant - must tolerate 3 hours
of intense rehab per day 5 days/week
• Physical, occupational or speech therapy
Skilled Nursing facility (SNF) - ANSWERpovides skilled nursing care/rehab (has to be a skill the nurse
must do)
Nursing facility (Nursing Home) - ANSWER• Provides room, meals, help with ADLs when
physical/mental health problems prevent living on one's own
• Termed custodial care
*NOT covered at all by medicare
Hi-Tech care at home - ANSWER• High- tech aide services (licensed nursing assistant) with additional
training
• An adult with spinal cord injury on a ventilator with feeding tube, child with cerebral palsy on a
CPAP, adult with amyotrophic lateral sclerosis w/ trach & feeding tube
Staff Nurse Role - ANSWER• Determine pt baseline prior to admission, assess post discharge needs,
assess support system, assess need for durable medical equipment (bedside toilet, bed, wheel chair),
communicate with case manager, etc.
Discharge Advocate - ANSWER• Makes appointments for follow-up, discusses tests/study results with
pt, provides phone reinforcement 2-4 days after discharge, insures PCP accepting responsibility
knows plan of care
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