Care That s Built Around You Kindred s Guide to Post-Hospital Care

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1 Care That s Built Around You What Is Post-Hospital Care? The easiest way to think about post-hospital care (sometimes referred to as post-acute care) is to define it as any care you receive after leaving a traditional hospital. Often, when people are released from a traditional hospital they need continued care to make a full recovery. Post-hospital care can also refer to the long-term management of a chronic illness (like diabetes or COPD) or disability. Where Do I Get Post-Hospital Care? Some of the confusion about post-hospital care comes from the variety of settings in which it occurs. This can range from long-term acute care hospitals to skilled nursing facilities (what most call nursing homes) to care in the home. For a clearer picture of what these different settings can provide, refer to the following pages for some brief descriptions.

2 Transitional Care Hospitals Long-term acute care hospitals (LTACS) are designed for patients who require intense, medically complex treatment for an extended period of time usually 20 to 30 days. LTAC patients typically arrive from the intensive care unit of a traditional hospital because they no longer require the full variety of tests and procedures offered by traditional hospitals, but still need a high level of care and expertise. Often, LTAC patients have several medical conditions at once and require treatment and therapy that is more intense and complex than can be provided in other settings such as nursing homes or rehabilitation facilities. Services May Include: pulmonary care (ventilator management and weaning) complex wound care rehabilitation dialysis IV antibiotic therapy pain management treatment for multisystem failure, stroke, trauma and other neurological injuries Inpatient Rehabilitation Hospitals Inpatient rehabilitation hospitals provide physical, occupational and speech therapy to patients who can tolerate an intensive rehabilitation schedule. Patients are given a minimum of three hours of therapy five days a week or 15 hours every seven days. The actual intensity of service is determined based on a patient s specific needs but will typically be a combination of minute therapy sessions provided throughout the day by physical and occupational therapists. Speech therapy will be included if necessary. Rehabilitation Programs May Include: brain injury cardio/pulmonary conditions hip fracture multiple sclerosis multiple trauma neurological conditions orthopedic injuries or recovery from orthopedic procedures Parkinson s disease spinal cord injury stroke treatment for lower extremity amputation

3 Skilled Nursing Facilities and Subacute Units Skilled nursing facilities are evolving in the kinds of care they provide. These facilities still serve the traditional role of caring for residents needing nonskilled care, such as bathing and dressing, alongside certain duties that can only be provided by Registered Nurses. However, they also provide rehabilitation services for residents who require shorter stays. These short-stay residents are generally recovering from surgery, stroke or other conditions and need physical or occupational therapies before returning home. At Kindred we refer to centers that have a focus on the needs of these short-stay residents as transitional care and rehabilitation centers. Programs and Conditions Treated May Include: respiratory conditions such as pneumonia and post-hospital COPD episodes cardiac conditions and post surgical care (grafts, valves, stents) wounds stroke recovery orthopedic injuries or recovery from orthopedic procedures neurological illnesses diabetes Subacute units are licensed and function as skilled nursing facilities. However, these units are housed within a hospital setting (both traditional hospitals and long-term acute care hospitals). Being located within the hospital enables the same doctors to coordinate care and help ensure safe transitions.

4 Home Health As the name implies, home health is for patients who cannot leave easily to access skilled nursing and/or therapy. They receive these services at home in order to recover, stay safe and remain independent. Home health can help you transition home after a hospital stay or be ordered by your doctor if your condition or your medications change. Visits (often two or three times a week) are focused on helping you remain independent by teaching you about your condition, helping you understand and take your medications at the right time and in the right amounts, working to help you with your nutrition needs, keeping you safe from fall risks and more. This care is often confused with 24-hour care that is lower skill. Home health is highly skilled and provides a personal plan of care to get you going again and keep you where you want to be most in the comfort of home. Services May Include: skilled nursing visits nutrition education and help physical, speech and other therapy to help with activities of daily living fall prevention medication reconciliation to make sure you aren t taking too much or too little of a drug, and to look for dangerous combinations medication and disease management training IV placement for antibiotics, inotropic therapy, hydration and other medications wound care help to appropriately manage symptoms Hospice If you are a patient faced with a life-limiting illness, hospice is intended to meet your complex physical and emotional needs as well as the needs of your family. Hospice brings an entire team that includes a medical director/physician to provide a plan of care and hospice expertise, nurses to give and coordinate care, hospice aides to help with grooming and bathing, medical social workers to make sure you get the community resources you need, volunteers to lend a hand with caregiving tasks, and spiritual care coordinators to help with spiritual needs. The focus of hospice is to make every moment matter and provide as much comfort and quality of life as possible on life s final journey. Services and Benefits May Include: pain and other symptom management nursing visits bathing and grooming assistance delivery and payment for medical equipment and supplies medications related to the hospice diagnosis spiritual care visits, when requested bereavement counseling help for caregivers and families struggling to care for a loved one help to appropriately manage symptoms

5 Personal Home Care Assistance Your care doesn t always end with medical needs. That s why we also provide personal home care assistance. This care may include personal hygiene assistance, meal preparation, transportation, companionship and respite care for caregivers who need time to run errands or just take time for themselves. Services May Include: bathing and grooming light housekeeping and laundry meal preparation transportation to appointments medication reminders respite care to give caregivers a break availability of live-in, hourly and shift care Assisted Living Facilities Assisted living offers assistance for residents who need help with certain activities of daily living from bathing to laundry services. Residents in assisted living don t require the 24-hour medical care that skilled nursing facilities offer. Assisted living communities vary in terms of their layouts, but generally they are much like apartment complexes with accommodations of different sizes as well as shared spaces to encourage interaction among residents. Assisted living communities will offer a variety of services depending on the facility. Amenities and Services May Include: private apartments with kitchenette three restaurant-style meals daily laundry and housekeeping transportation to and from activities and/or medical appointments Registered Nursing services and emergency call response systems ready 24 hours a day wellness and fitness program with dietitian computers and WiFi access beauty salon

6 What Else Should I Know? First, the more you know about your care or the care of a loved one, the better. So just having this guide is a great step forward. Next, having a good grasp of your current condition and medical history is essential. Soon, electronic medical records will help share information between care settings, but until we see more of this, you may need to answer questions over and over. So you need to know as much about your situation as possible. Consider using a Personal Health Record to keep track of this information. When you are moving between care settings, find out everything you can. How is the reputation of the provider or the facility? Does your doctor recommend it and have a good relationship with the nurses, therapists and other physicians there? Consider the value of a national provider with leadership and clinical resources to bring you the best care possible. Finally, know that you have the right to ask all the questions you want until you are comfortable, and that you have the right to choose where you receive care. Recovery can take time, so it s essential to have a good relationship with those who are providing care. The more confidence you have in your provider, the more confidence you can have in your recovery. How Can Kindred Help? Making healthcare decisions can be complicated. It s hard to find an expert you can turn to for help, or even know what options are available. That s why we created our Contact Center. Call us at KINDRED, and you can talk to a Registered Nurse who will take the time to listen to you, discuss your situation, and advise you about options while helping to answer your questions. At Kindred, our total commitment is to post-hospital care, and our dedication is to those who need our care. So remember, whatever your situation however complex and difficult healthcare can seem we re always just a phone call away KINDRED

7 KINDRED S HOUSTON INTEGRATED CARE MARKET SERVICES Central Referral Line: Tomball Conroe 45 Spring Humble Dayton TRANSITIONAL CARE HOSPITALS Kindred Hospital Bay Area 4801 East Sam Houston Parkway S. Pasadena, Texas fax Kindred Hospital Baytown 1700 James Bowie Drive Baytown, Texas fax Kindred Hospital Clear Lake 350 Blossom Street Webster, Texas fax Kindred Hospital Houston Medical Center 6441 Main Street Houston, Texas fax Kindred Hospital Houston Northwest Fallbrook Drive Houston, Texas fax Kindred Hospital Spring 205 Hollow Tree Lane Houston, Texas fax Kindred Hospital Sugar Land 1550 First Colony Boulevard Sugar Land, Texas fax Kindred Hospital The Heights 1800 W 26th Street Houston, Texas fax TX TDD/TTY# Sugar Land 7 8 Jersey Village 69 Kindred Hospital Tomball 505 Graham Drive Tomball, Texas fax Kindred Hospital Town and Country 1120 Business Center Drive Houston, Texas fax INPATIENT REHABILITATION HOSPITALS Kindred Rehabilitation Hospital Clear Lake 655 E Medical Center Boulevard Webster, Texas fax Kindred Rehabilitation Hospital Northeast Houston McKay Boulevard Humble, Texas fax HOUSTON 6 Pearland Pasadena Highlands HOME HEALTH, HOSPICE AND IN-HOME PHYSICIAN CARE Kindred at Home For service information, contact a location below or visit Bellaire HOME HEALTH: fax HOSPICE: fax Conroe HOSPICE: fax Humble HOME HEALTH: fax South Houston HOME HEALTH: fax HOSPICE: fax House Call Doctors An Affi liate of Kindred House Calls IN-HOME PHYSICIAN CARE: fax League City 2 Baytown For more information, visit CONTINUE THE CARE Dedicated to Hope, Healing and Recovery 2015 Kindred Healthcare Operating, Inc. CSR , EOE