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What's Transitional Care All About?

November 16, 2021
Categories: Our Community

Written by VMRC Transitional Care admissions manager, Daniel Shickel.



Transitional Care is an important service VMRC offers in fulfilling our mission of helping folks age well and live fully. Hospitals and Medicare call this short-term rehabilitation service “skilled nursing,” but we prefer the more fitting term of Transitional Care (also referred to as “TC”). I describe the purpose of TC as bridging the gap between a hospital stay and getting back home safely and successfully

We serve patients that admit to us from the hospital for various reasons — from falls and fractures to cardiac issues and strokes to pneumonia. We also accommodate pre-scheduled procedures. If you have a scheduled inpatient procedure coming up, call me to ensure that we reserve a room for you in advance!

Our multidisciplinary team is made up of doctors, nurses, physical therapists, occupational therapists, speech therapists and dieticians who will customize a care plan for each patient’s recovery based on their individual goals and needs.  

Every TC patient has their own completely furnished private room with a private bathroom. In 2019, we built a brand-new state-of-the-art therapy gym equipped with modern equipment so that our therapy team can best support each patient in regaining their independence. We even built an outdoor therapeutic walking trail! 

Transitional Care also includes its own dining venue, The Grille, which offers dine-in or grab-and-go meal options like salads, sandwiches and a daily featured item. 

Requirements:
VMRC requires that Medicare or a Medicare supplement/replacement plan be the primary payer for a stay in TC. Medicare requires a minimum of a three-night inpatient stay in the hospital before covering the costs of inpatient short-term rehab. Medicare replacement plans don’t always require a three-night stay, but they do typically require a review and prior authorization before leaving the hospital to ensure that TC is the appropriate level of care.

COVID safety:
During the last 18+ months, we've had to be flexible with ever-changing guidelines from state and federal agencies as it relates to the coronavirus pandemic in a nursing care setting. 

The health and safety of our current patients and staff are VMRC’s highest priority. We can currently accommodate COVID-positive patients in Transitional Care while strictly following all Virginia Department of Health and CDC guidelines. Current recommendations state that a nursing facility cannot admit a COVID-positive patient any sooner than 10 days after the initial positive test. This ensures that the patient is outside of the window of transmissibility.

Our team members go above and beyond in terms of safety and wear personal protective equipment, frequently sanitize spaces and social distance in all common areas such as the therapy gym and The Grille. Each patient is also closely monitored for symptoms that are common to COVID-19.

Vaccination is currently not a requirement to admit to TC, but fully vaccinated patients have the benefit of not needing to wait a 14-day quarantine period before being permitted to have visitors.

Misconceptions:
A common misconception is that TC is only available to VMRC residents. While we do prioritize our residents for available rooms in TC when they need it, most of our patients are external community members that do not live on campus. In fact, TC has been a referral source for all facets of our community. Patients and families are often so impressed with the care and hospitality they receive, they inquire about becoming residents of VMRC or members of the Wellness Center!

Another mistaken belief is that once you admit to Transitional Care, the next step is automatically assisted living or long-term nursing care — that’s not true at all! Most of our TC patients can go back home or to their prior living arrangements. If this is not an option, our outstanding Patient Navigator and discharge planning team will help you explore all of your options for extended care.

Ask me!
As the TC admissions manager, my job is to make a transition from the hospital to VMRC as smooth as possible for patients and their families. Over the years, we’ve worked diligently to cultivate close relationships with the local hospitals to achieve seamless transitions of care.  

Questions? Reach out!

Daniel Shickel, MBA, LNHA
Transitional Care Admissions Manager
(540) 564-3502
dshickel@vmrc.org

View the Transitional Care space!

Transitional Care, Private Rehab Suite

Transitional Care, Therapy Gym

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“The response from the VMRC community of staff and residents has been quite welcoming.  We've enjoyed meeting friends old and new which has been very enriching.”

- New VMRC Resident, 2018