Case Study: Palmetto Subacute Care Center (December 2018)

Patients Age: 88-years-old
Admission Date: 11/05/2018
Admitted From: Kendall Regional Center
Discharge Date: 12/10/2018
Discharged To: Home
Length of Stay: 35 Days
Reason for Stay: Syncope and Collapse.
How did this patient hear about Palmetto Subacute Care Center? The Social Worker from Kendall Regional Hospital.

Details of Experience:

Maria is an 88-year-old female who arrived at the emergency room, stating that she just felt “bad.” She had some difficulty expanding upon this, but clarified by saying she had generalized weakness and fatigue. She denied focal weakness, numbness, fever, shortness of breath, abdominal pain, and urinary symptoms. Maria was eventually discharged from the hospital; however, according to Maria’s son, Maria had a syncope episode around the time of discharge and was readmitted for acute care.

Her doctor recommended physical therapy for roughly 30 days before returning home, thus Marisa sought therapy and skilled nursing services here at Palmetto. Maria’s journey began on November 05, 2018.

When she arrived to our community, she was greeted by our interdisciplinary team through a warm signature welcome. Upon arrival, she was very weak and was unable to walk steadily and perform everyday living activities. On her second day here at Palmetto, Maria was evaluated by the occupational and physical therapy teams to set a personalized plan of care in place to begin her healing journey.

Throughout her stay, Maria also received frequent chest x-rays as ordered by her attending cardiologist.

Maria received both types of therapy, five times a week, for four weeks. Occupational therapy focused on ADL’s, consisting of re-training coordination, safety, balance, therapeutic activities, and patient caregiver education. Physical therapy focused on bed mobility, transfer, gait training, therapeutic exercises, balance, endurance, and safety skill instructions.

Maria worked diligently and trusted the team here at Palmetto. From keeping her belongings safe, to making sure that she was receiving the best care, the Palmetto staff were proud to be a part of her journey.

Maria was discharged home as planned. We made sure that she was all set and ready, from medication education to transportation, we made sure that Maria had the right tools to have a successful return home. Maria and her son were extremely happy with the care provided to Maria at Palmetto.

“I found the therapy I had here really helpful. My stay here was very good. All those in nursing, nursing assistants, and physical therapy are great.” – Maria

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Case Study: Palmetto Subacute Care Center (November 2018)

Patients Age: 68-years-old
Admission Date: 10/17/2018
Admitted From: Kendall Regional
Discharge Date: No DC
Discharged To: N/A
Length of Stay: 44 Days
Reason for Stay: Other Bilateral Secondary Osteoarthritis of Knee.
How did this patient hear about Palmetto Subacute Care Center? Last year she had the same surgery on her left knee. She decided to came back to our community.

Ms. Fernandez arrived to Palmetto Subacute Care Center from Kendall Regional Hospital on October 17, 2018 after a two day hospitalization. Ms. Fernandez was admitted for a right total knee replacement, something she was somewhat familiar with as her left knee was replaced on the 22nd of September.

It was discussed that she would need skilled care in efforts of returning her home. The hospital assisted Ms. Fernandez and her family with the selection process, electing to transfer to Palmetto for rehabilitation upon hospital discharge.

She worked with our team and her recovery journey was coming along smoothly. Much to her surprise and comfort, Ms. Fernandez’s healing was noticeable and continuously successful.

Ms. Fernandez was welcomed and escorted to her room when she arrived to our community, and she was attended by our nursing staff shortly upon arrival. Already comforted in her room, Ms. Fernandez recalled some team members whom she has worked alongside in the past during her first experience at Palmetto. Needless to say, she had inquired and requested the same caregivers to assist her during her second journey. The team was confident in Ms. Fernandez’s abilities and potential for a full recovery.

Ms. Fernandez received physical therapy five days a week. Her continued physical therapy services were necessary in order to assess functional abilities.

Ms. Fernandez received occupational therapy also five days a week. She required skilled occupational therapy services to assess safety and independence with self care and functional tasks of choice.

Ms. Fernandez also has a diagnosis of Parkinson’s disease, and requires a little more assistance from our nursing team due to their advanced skills training with patient care. Ms. Fernandez had this to share about our team here at Palmetto, “They are a love, they come every day to work with a smile, and they help me with everything. Thanks Irasema and Regla for all you do.”

Ms. Fernandez continues her journey everyday in efforts of a fill recover and a safe return home.

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Professional of the Quarter, Janelys Garcia de Jesus

Congratulations to our Professional of the Quarter, Janelys Garcia de Jesus, CNA at Palmetto Subacute Care Center in Miami!

Garcia de Jesus has been working at Palmetto for six years; it was her first position as a CNA after graduation. “I am so happy, and so grateful for the nomination. I enjoy time with my patients and the relationships I have with my team members. I am so happy to be recognized by my patients and team.”

When asked the best part of her daily role, she shared spending time with her patients, and ensuring that they are good and receiving the care that they need. “The happiness of my patients is most important. The most challenging part of my job is when a patient passes away,” she began. “It is so challenging, they are like family.”

She shared, “I am proud to be noticed of my accomplishments and work each day. I will continue to work very hard; I love my job and Palmetto. My goal is to become Professional of the Year!”

Janelys Garcia de Jesus is now a finalist for the Professional of the Year contest; the winner will be announced during Nursing Home Week 2019!

Congratulations Janelys Garcia de Jesus, you are #TheCareRiteDifference!

Case Study: Palmetto Subacute Care Center (October 2018)

Patients Age: 83-years-old
Admission Date: 09/08/2018
Admitted From: Baptist Hospital
Discharge Date: 10/29/2018
Discharged To: Home
Length of Stay: 51 Days
Reason for Stay: Nontraumatic Acute Subdural Hemorrhage
How did this patient hear about Palmetto Subacute Care Center? From Social Worker at Baptist Hospital.

Ms. Mirurgia Roque Pastrana is a 83-year-old female from La Habana, Cuba. She came to the United States of America in 1960, and lived in New York. She has two sons, both in California, and she is planning to move there to be near them. Ms. Roque arrived to Palmetto Subacute Care Center after hospitalization at Baptist Hospital post subdural hematoma. She suffered a mechanical fall on July 25th, which resulted in a small left subdural hematoma. Ms. Roque was evaluated by neurosurgery and was noted with dysarthria, right-side weakness, and confusion. When she arrived to Palmetto, she was welcomed by all nurses and technicians. Shortly after, the dietician spoke with her and reviewed her diet. Later in the day, she was evaluated by all therapy teams. The next day, our Director of Concierge discussed therapy, menus, and recreational programming with Mrs. Roque.

Ms. Roque was referred to physical therapy due to her decrease in strength, decrease in transfers, reduced ability to safely ambulate, decrease in functional mobility, decreased neuromotor control, reduced ADL (Activities of Daily Life) participation, and reduced static and dynamic balance.

Ms. Roque increased her independence and was able to facilitate with all functional mobility, promote safety awareness, enhance rehabilitation potential, facilitate motor control, increase coordination, improve dynamic balance, enhance fall recovery abilities, increase functional activity tolerance, and minimize falls.

Ms. Roque was referred to the occupational therapy team to gain the ability to follow cues. She was presented to the therapy team with significant declines in functional mobility and overall ADL performance, and required the need for skilled therapy services in order to improve functions for a safe return home. After a week, Ms. Roque improved with toilet transfers and toileting tasks using grab bars and efficiently performed lower-body dressing with independence, Ms. Roque is fully oriented and gives a good reliable history; she is very active and able to ambulate independently. Ms. Roque requested to be discharged home on October 29th, 2018, and was. She was transported by her sister; she no longer needs any medical equipment or Home Health services. Ms. Rogue discharged from our community in good condition, stating that she was very pleased with her recovery and the professionalism of the staff!

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Case Study: Palmetto Subacute Care Center (September 2018)

Patients Age: 71-years-old
Admissions Date: 08/24/18
Admitted From: Jackson Memorial Hospital
Discharge Date: 09/10/18
Discharged To: Home
Length of Stay: 17 days
Reason for stay: Fracture of Left Acetabulum
How did this patient hear about Palmetto Subacute Care Center? Social Worker from Jackson Hospital

Mr. Reyes arrived at Palmetto Subacute Care Center on August 9th, 2018 after a hospitalization at Jackson Memorial Hospital. He is a 71-year-old patient who was unfortunately involved in a motor vehicle collision. He did not lose consciousness as he thankfully did not hit his head during the accident. He was admitted to a local trauma center, where he presented with a left closed acetabular fracture, left inferior pubic arm fracture, and intrapelvic hematoma. The orthopedic surgeon on staff was consulted for management of the fractures. After a successful procedure, Mr. Reyes was notified that he would need intensive inpatient rehabilitation to support his healing. He and his family were given a list of skilled nursing centers, where they ultimately selected Palmetto Subacute Care Center!

Mr. Reyes was warmly greeted by multiple professionals of the Palmetto team who anticipated his arrival. He was evaluated by both the physical therapy team (PT) and occupational therapy team (OT), and a treatment plan was put in place based on their objective findings. The team also developed a discharge plan and goal in coordination with his care plan.

Mr. Reyes was able to perform bed mobility with maximal assistance and was able to transfer to his bedside chair using a standard walker with maximal assistance, requiring frequent verbal cues to maintain non-weight-bearing (NWB). Mr. Reyes was motivated and willing to participate with therapy. He is currently able to tolerate two hours of activity out of bed. Mr. Reyes benefitted from compressive PT/OT in an acute intensive rehab setting, as opposed to a lower level of care in efforts to improve functional mobility. His goal was to continue intensive therapy in hopes of returning to an independent status and a proper transition back home.

Mr. Reyes was known to be a very cheerful person during his time with therapy. He would even often bring his own music for extra motivation. “I already feel strong and I think it’s time to go home and go back to work,” shared Reyes.

On September 10th, Mr. Reyes was discharged home! After a short two week stint at Palmetto, he regained independent status in transfers. Our social services team here at Palmetto arranged for Mr. Reyes to receive continued clinical care services while home. As he was departing and saying his final goodbyes, Mr. Reyes shared, “I will miss them [the Palmetto team] a lot, and I will come back because truth be told, I felt very good with the care I received from everyone!”

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