Does anyone have any experience with managing a SNF that takes trach's and Vents?
With hospitals starting to overflow beyond IP capacity on an almost daily basis hospitals are now looking to SNF's to take patients with trach's and vents. I would love to talk to someone else who is experienced with managing a SNF RT department.
The idea that nursing and RT will share "tasks" is a very difficult way to staff, and when there are callouts- the RT's are expected to absorb all the RT related work, which is difficult to achieve. There is reluctance in wanting to staff 2 RT's 24/7, however nursing call outs & vacancies appear to be up and down.
In my mind from a respiratory standpoint of care, vents and trach's in a SNF frequently require the same amount of direct time to maintain their baseline RT status as they do in the hospital setting. However there appears to be a disconnect between getting SNF leadership to understand that. These patients still require trach care, suctioning, vent checks (less frequently, but still checked), equipment change outs and sometimes routine hyperinflation therapy/ HHN treatments.
The paid Reimbursement from insurance companies and CMS does not appear to support these RT patients very well in the SNF setting. Readmissions to Acute Care are a focus, and over the years the patients in the SNF's are more acute then 5-10 years ago.
Hospital technology has changed and improved, however that seems to have resulted in more complex patients coming into the SNF's for care. The SNF's margins are so small and nursing ratios are high in comparison to hospital ratios. In my observation, SNF's have the least amount of budgeted help, resources, technology, IT technology, and helpful products. The KSA's of the nursing staff caring for these patients can also be a challenge due to the continual competition with the acute care hospitals to recruit the best and brightest nursing staff. Benefits are usually less in the SNF's then hospitals therefore recruiting and retaining solid staff can be a challenge.
Please feel free to contact me directly if you have any experience in this arena. I am open to thoughts and suggestions on this topic.
I would love to talk about this topic/ email about it.
Thank you,
Joanna