Ventilator Management Skilled Nursing Facility

There has developed an increased need for ventilator management in skilled nursing facility. Some patients need to use a ventilator for a short period of time, while others use ventilator services on a long-term basis. As more patients need ventilator care, several new conditions and positions are necessary to meet this increased need. Respiratory therapists and pulmonary specialists are needed to oversee patient care. In addition, new regulations and guidelines are needed to guarantee that patients’ needs are met. Finally, stringent documentation is needed to demonstrate progress and show any changes that are needed in ventilator care.

Qualified medical professionals are needed to administer ventilator management in a skilled nursing facility. These qualified professionals include respiratory therapists, pulminologists (or respiratory doctors), and trained nurses. Respiratory therapists are a necessity and must be onsite at all times to dispense medication through ventilation, oversee life support systems, and provide respiratory interventions when necessary. Respiratory therapists are specially trained and have specific skills, which are necessary in operating a ventilator. Pulmonologists must be involved in respirator patients’ treatment, as they are able to prescribe the most accurate and specific medication and medical treatment for patients that are on a ventilator. In addition, the nurses that will be involved in respiratory patients’ care must be specially trained in ventilator management, as they will be the most frequent point of contact for any patient using a ventilator.

New regulations and guidelines to govern the care of patients who use a ventilator must be followed to insure the best care for each and every patient. Standards for ventilator management in a skilled nursing facility include the admission criteria, assessment of ventilation and oxygenation needs, emergency and life support guidelines, and back-up requirements. These regulations are intended to provide the best care for every patient that requires ventilator assistance. Other regulations govern the emergency alarms that ventilators use, transfer to emergency care facilities, and protocol in the event of a power outage. These guidelines not only assure that the medical needs of each patient are met, but also provide guidelines in the event of an emergency situation.

Each skilled nursing facility must stringently document the patient’s progress and care when using a ventilator. This documentation includes patient’s progress, any abnormalities, side effects, or other symptoms that the patient experiences when using a ventilator. The documentation is used by medical doctors to prescribe treatment options, by respiratory therapists in dispensing medication and other treatments, and by other skilled nursing staff when following a patient’s progress and making decisions for the patient.

Ventilator management in a skilled nursing facility is a detailed process that involves a team of dedicated professionals, including respiratory therapists, pulminologists, and trained nursing staff. There are strict regulations and guidelines that must be followed to protect the patient and assure the best care is provided. Stringent documentation must also be kept to show a patient’s progress, any abnormalities, and to guide future decisions. Whether the patient uses a ventilator for the short or long term, following these protocols assures that the highest quality respiratory care is given to every patient who has need of ventilator services.

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  1. debra pearlman
    Posted June 29, 2011 at 3:46 am | Permalink

    my dad is 81 yrs old, has been resident of nursing home for last 2 + yrs. He is on oxygen-kept set at 5 but this past week his level dropped to 80’s and they sent him to local inpatient hospital, he was there for3 days, discharged at 5pm on 3rd day, when he was hospitalized they had him on full face oxygen, setting to 15, he stabilized, O2 level reading 97 with just small O2 unit, 8 hours later, nursing home was calling for paramedics to transport him right back to hospital he had been discharged from earlier that day. Nursing home can not raise his O2 level to keep him comfortable or to observe him like hospital or hospice could. The family has agreed and is noted in his chart-“DNR”. He has been in hospital since being readmitted, BUT NOW NURSING HOME REFUSES TO TAKE HIM BACK, THE HOSPITAL WANTS TO RELEASE HIM and find a Hospice that will treat him for his respiratory irregularity. He has had triple bypass, anurism removed, kidney failure, etc, over the last 2 years, but when nursing home has problem, he is admitted to hospital. Social worker there has told our family that his insurance coverage, which is Medicare and Maryland Medical Assistance,that they will not be responsible for charges incurred for just the respiratory irregularities/failure, as he is not ILL ENOUGH TO JUSTIFY THESE CHARGES. This has occurred once before over last 2 years, his O2 level dropped which caused possible heart failure, he was in ICU for 7-10 days, diagnosis also stating kidney failure, fluid on his lungs, . My point is that if hospital will not keep him, nursing home will not take him back as resident, WHERE DO WE GO FROM HERE? We have been told that ventilator management is not enough for any medical facility except a ventilator facility, but when O2 level is unstable, all of these other problems which i mentioned above could develop only due to age, weight (220+lbs), and has occurred in the past. Do you know if VA hospital could assist him, or do they offer hospice type care?..Our resident state is Maryland, Baltimore County. hope you can reply or suggest. thank you for your time

  2. Allie Roush
    Posted May 12, 2015 at 1:19 pm | Permalink

    I have a friend that needs to find a skilled nursing facility in Oklahoma City that she can be moved to. She has a feeding tube in her stomach, a Foley, a trachea tube with a machine and a ventilator in the trachea tube. She has MS and can not feed herself or much of anything else. She is on medical retirement with a private insurance and DHS. We desperately need to find a nursing home that will take her in or close to Oklahoma City, OK. Can anyone help us find one please ? We don’t know how to search on the internet.

    • Posted May 26, 2015 at 3:07 pm | Permalink

      Hi Allie – perhaps try: George Nigh Skilled Nursing Fa Okmulgee OK (918) 756-9211

    • Robin Calabrese
      Posted June 17, 2015 at 5:00 pm | Permalink

      Hi Allie,
      I am facing the same issue here in NY. My husband has all of the same issues you just mentioned that your friend has plus a stage IV that he received in a local hospital. There is a nursing home near me that takes trachs and vents but they won’t take him because of the stage IV. The one he was in won’t take him back due to his now needing the vent and no one knows if he will be able to get off of it. The hospital he is currently in wants to send in to a place in NJ, 45 mins to an hour away, for 30 days. They claim it does extensive rehab. But, what if he can’t get off the vent and they can’t get the wound healed? Then how do I get him back to NY? What about his NY medicaid? Is it going to have to change to NJ medicaid? I have no idea what the NJ guidelines about medicaid are compared to NY. And how do visit him? He only really has myself, our daughter and his one sister that visit him. I have my own health issues and our daughter and his sister both work. I’m at my wits end.

      • Posted June 19, 2015 at 4:39 pm | Permalink

        Hi – hoping all works out, here are some New York facilities that may be helpful:
        John J Foley Skilled Nursing Facility Yaphank NY (631) 852-4400
        Manor Oak Skilled Nursing Faci Jamestown NY (716) 484-9181
        Manor Oak Skilled Nursing Faci Warsaw NY (585) 786-2211
        Manor Oak Skilled Nursing Faci Cheektowaga NY (716) 837-3880
        Mary Mcclellan Skilled Nursing Cambridge NY (518) 252-2764
        Mercy Hospital Skilled Nursing Buffalo NY (716) 828-2300
        Michael Malotz Skilled Nursing Yonkers NY (914) 964-4695

  3. Nancy Clark
    Posted June 8, 2015 at 9:38 pm | Permalink

    My niece has VHL and has been rendered quadraplegic due to surgery. We are in the St. Louis area and are looking for a long term skilled care that will take her. She has a feeding tube, foley, and trach tube with ventilator. The acute care facility she is currently in is trying to ship her off to Iowa! We are also desperately trying to find a facility in this area.

    • Posted June 10, 2015 at 3:34 pm | Permalink

      Hi Nancy – we only are aware of St Anthony’s Medical Center in the St Louis area – perhaps they can be of assistance to you and your niece. Hope this may help.

  4. Jacks Smith
    Posted July 8, 2015 at 11:29 pm | Permalink

    I am in the Paducah, Kentucky area and am looking for a SNF that can handle a trache, colostomy, and feeding tube. Any suggestions?

    • Posted July 13, 2015 at 4:02 pm | Permalink

      Hi – the closest facility we were able to locate is in Alabama:
      Mary Lewis Skilled Nursing Fac Birmingham AL (205) 975-7064

  5. Debbie
    Posted August 27, 2015 at 9:56 pm | Permalink

    Is any one aware of a skilled nursing facility for my dad has a ventilator , foley, trying to wean him to a trach collar, according to nurses at select speciality hospital in Houston tx there are only 2 places Spanish meadows in Katy and liberty health care in liberty tx I did not like either one

    • Posted September 1, 2015 at 6:09 pm | Permalink

      Hi Debbie – those are the only two we know of, but will try to find others and will let you know — Ron

  6. DAB
    Posted September 19, 2015 at 3:48 pm | Permalink

    Is there a facility that will take a patient on dialysis and low level vent in south carolina besides the hospitals?

    • Posted September 25, 2015 at 7:59 pm | Permalink

      Hi – we’ve been unable to locate any facilities besides hospitals. We wish you all the best —

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