Bordeaux Long-Term Care Opens Respiratory Unit on Nashville Medical News

Bordeaux Long-Term Care Opens Respiratory Unit

By: CINDY SANDERS

Recently, Bordeaux Long-Term Care (BLTC) added to its clinical offerings by opening the Respiratory Center of Middle Tennessee to bridge a gap that has existed between an inpatient hospital stay and return home for patients with dependence on mechanical ventilation.

“Because we’re large, we offer a lot of services you often wouldn’t find on site,” said Barbara Morrison, BLTC administrator. She noted the 100-acre campus includes an onsite pharmacy, full-time medical director, 419-bed home, inpatient and outpatient rehabilitation programs and a Long-Term Acute Care hospital in partnership with Kindred Healthcare.

What BLTC didn’t have was a solution for ventilator-dependent patients who were medically stable enough to be discharged from the inpatient setting but not suitable to go home on a maintenance program. An “in between” option wasn’t available in this part of the state. “They (patients) went out of state for services, or … if a bed was available … to Knoxville or Memphis,” noted Morrison.

With Bordeaux’s established LTAC and rehab programs, plus their experience with caring for patients with tracheostomies, moving forward with a respiratory center seemed like a natural progression. “We felt like this was the next logical step in that continuum of care,” Morrison explained. However, she continued, the administration believed it would be crucial to choose the right pulmonary partner for this public/private venture.

Enter Linde RSS, an international respiratory company headquartered in Germany but with a corporate presence in Tennessee. Linde RSS provides a range of pulmonary services, particularly for highly complex patients. The company utilizes its REMEO^® clinical care model to help reduce ventilator dependency. Remeo is Latin for “I return home,” which is the desired outcome of the partnership between Linde and BLTC.

The new Respiratory Center of Middle Tennessee focuses on ventilator dependency, noninvasive ventilation, extended ventilator weaning services, acute and chronic respiratory distress, respiratory rehabilitation, family training for home care, high-low oxygen and patients with COPD and/or pneumonia. The center utilizes redundant monitoring to maximize patient safety. There is onsite case management, and pulmonologist Clyde Heflin, MD, is directing respiratory services on a part-time basis under the new partnership in addition to his work at Saint Thomas Hospital.

Morrison said in the acute setting, the goal is typically to wean vent patients in 30-40 days. “In a long-term setting like ours, the time frame can be extended,” she noted, adding specific protocols are followed to keep a patient progressing to the ultimate goal. “Our partner, Linde, has well-developed clinical strategies to support weaning from the vent.”

Patient Referrals

Referrals are handled through Central Intake

Phone: 865-687-0077; Fax: 865-687-0706

Required with the transfer of an appropriate candidate:

Completed discharge summary sent with patient or faxed prior to arrival;
Last three days of progress notes, vent sheets, respiratory notes and therapy notes;
Lab results including Comprehensive Metabolic Panel, CBC w/diff, PT/PTT, sputum for C&S and gram stain and ABG;
Chest x-ray within the last 48 hours;
Copies of echocardiogram, CAT scan, sleep study and PET if completed during present admission.

Accepted Payer Sources:

TennCare
Medicare
Commercial Insurance

For those who must look at a longer-term solution than a typical inpatient stay, Morrison also said the pulmonary unit at BLTC offers more of a home-like atmosphere and allows pets and encourages visitation by friends and family members. The campus also incorporates performances by Musicians on Call, an intergenerational volunteer program and varied recreational programs. “Because of our nursing facility, we have a commitment to provide a home for folks in addition to meeting their medical needs. I think it helps people approach their rehab in a more holistic manner,” Morrison said.

The 10-bed unit admitted the first patient in late May. While Morrison said some residents would stay indefinitely, the program has already seen several patients successfully weaned from their ventilator and able to return home. The demand for beds, however, remains high.

“We’re running quite full right now with the 10 beds,” Morrison said. “We expect to expand to 16 beds in the next couple of months.”