I manage both inpatient and outpatient dialysis programs for our area. Our Social Workers are finding it more and more difficult to locate dialysis facilities or LTAC's who will accept sub acute patients with dialysis needs. This is resulting in our hospital inpatient wards managing patients who no longer meet inpatient criteria. When I go to ANNA or NRAA meetings I hear from other dialysis Administrators how they too are struggling with placement of these type patients in an increasing intensity. Are there any "best practice" models out there we could resource? Thanks for any info.

Just a thought: Most outpatient dialysis units are really not staffed/equipped for intensive care patients. It is possible for longterm facilities to become certified to provide dialysis within the facility.

It's possible, but not terribly feasible. The start-up costs are considerable and the reimbursement, if you're only doing chronic dialysis, wouldn't even cover operating costs let alone the capital expenditures. As an acute care hospital with both Skilled Nursing and Subacute units, we've struggled with this issue for years. If we had a dialysis facility there would be no problem. We provide free, and quite costly, dialysis to our long term care patients through a contracted provider. As you can imagine, we don't jump at the opportunity to take on more recurring, unreimbursed expenses.

I'd be interested in a discussion as my organization is currently looking at ways to meet the dialysis needs for sub acute patients in nursing home settings. Reply to: cdanliker@aol.com

quote:

Originally posted by cats:
I manage both inpatient and outpatient dialysis programs for our area. Our Social Workers are finding it more and more difficult to locate dialysis facilities or LTAC's who will accept sub acute patients with dialysis needs. This is resulting in our hospital inpatient wards managing patients who no longer meet inpatient criteria. When I go to ANNA or NRAA meetings I hear from other dialysis Administrators how they too are struggling with placement of these type patients in an increasing intensity. Are there any "best practice" models out there we could resource? Thanks for any info.