By Brandi Vela

Once it comes time to discharge or transition from the hospital, you may need to receive continued support as you recover. Your care team at Delta County Memorial Hospital (DCMH) will help you determine the type of post-acute care that you may need, and the Transitions Post-Acute Care (T-PAC) program might be the best option for you. This program allows patients to safely and comfortably transition from an acute hospital stay to the next level of care through continued skilled nursing and rehabilitation services.

What is the Transitions Post-Acute Care (T-PAC) / “Swing Bed” Program?

The T-PAC program is a “Swing Bed” program. This type of program is primarily a Medicare-funded program that provides short-term, skilled care in a hospital setting. If you do not have Medicare, you may still hear this terminology used to describe your rehab stay, even if your insurance does not use the term. The goal of our program is to help you recover from your medical illness, injury, and/or surgery as quickly as possible.

The goals of post-acute care are different than when you were in the hospital for acute care.

With your care team, you work together to enhance your well-being throughout the care process to enjoy life as you did before your acute care stay. This means doing things such as getting out of bed every morning, performing personal hygiene, getting dressed every day and more.

How do I know if I’m eligible for T-PAC and if my insurance will cover it?

The T-PAC staff will work with your individual insurance company to authorize eligibility for your rehabilitation stay. For Medicare Part A, we comply with current benefit guidelines as determined by Medicare Rules. This may include a requirement to have spent at least three midnights as “acute inpatient status” at a hospital within the last 30 days. If you have any questions regarding your eligibility or insurance, please contact the T-PAC MDS Assessment Coordinator at the number listed below.

How long will I stay in the T-PAC program?

Each rehabilitation stay is different based upon specific needs. DCMH also follows all applicable state and federal laws regarding your length of stay. Our interdisciplinary care team meets weekly to assess your progress. As you get closer to discharge, you may interact with team members daily to assist with your needs. If you have questions about how many days your insurance has authorized, how many days you have used, how many days you have left, or have concerns about your discharge, please contact the T-PAC MDS Assessment Coordinator or Case Manager.

What health care professionals will be part of my care team?

DCMH has a team of highly skilled healthcare providers and other team members to help you in your rehabilitation process. The members of the DCMH T-PAC team include: MDS Assessment Coordinator, nurses and CNAs, Nutritional Services, case manager, hospitalist physician (MD/DO), therapists (PT/OT/ST) and therapy aides, housekeeping and pharmacist (PHARMD).

Your care team will hold weekly meetings with you to discuss your progress, discharge plans, and to answer any questions you may have. This is a great time to interact with the entire team.

If your family is interested in being part of the weekly Care Team Meeting, simply let the T-PAC MDS Assessment Coordinator know.

Why should I choose the T-PAC Program at DCMH?

When you transition to the T-PAC program, you will continue to work with highly skilled caregivers and care team members. Your care team will include a physician who is on staff 24/7 to answer your questions, monitor your needs and work with you in your healing process. In addition, the T-PAC program has a low nurse to patient ratio that often exceeds the ratios at skilled nursing facilities. Also, because the T-PAC unit is within the hospital, any diagnostic studies, such as X-rays, etc., are on-site.

The T-PAC program at DCMH is accessible and simple. We hope to offer our community members the transitional care that they need, from people they know and trust, close to home.

Where can I get more information about the T-PAC Program?

If you are interested in learning more about the T-PAC Program at DCMH, please contact us by calling (970) 874-6015 or by visiting us online at deltahospital.org/post-acute-care.

Brandi Vela, RN, BSN, RAC-CT is with Delta County Memorial Hospital.

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