SF Auxiliary 2015
Special Project
'Transitional Care'
Children recovering from serious illnesses are sometimes well enough to be discharged from the hospital
but they still require close supervision by their healthcare team before they can return home.
In these situations, hospitals look to facilities around the Bay Area called
'transitional care or sub-acute care'
facilities which provide medical care in a safe area for complex patients.
Room and board plus ancillary costs for a one day stay at a 'transitional care facility'
is approximately $2,500, in comparison to a hospital stay at approximately $6,300.
but they still require close supervision by their healthcare team before they can return home.
In these situations, hospitals look to facilities around the Bay Area called
'transitional care or sub-acute care'
facilities which provide medical care in a safe area for complex patients.
Room and board plus ancillary costs for a one day stay at a 'transitional care facility'
is approximately $2,500, in comparison to a hospital stay at approximately $6,300.
The San Francisco Auxiliary for Children
aims to raise $20,000 toward Transitional Care
(see middle section below)
The Association of Auxiliaries, to which we are part,
aims to raise $170,000 to assist for families
when caring for a child 'almost ready to return home'.
FAQ's
How many children/families are referred to Transitional Care annually?
For transitional care assistance, funds would support patients needing some type of transitional care assistance/support. These are patients who do not meet sub-acute level of care to be discharged to a sub-acute facility (for our patients who meet criteria for sub-acute facilities these services are normally covered by insurance), but cannot be discharged home because the patient needs further care assistance. For example, patients identified as needing a targeted clinical intervention that may not be managed at home/have failed to be managed at home. The transitional care assistance options require much creativity, and most of the time would need to fall under the following options (although not limited to these):
1. Skilled Nursing Facility
2. Sub-acute facility
3. Home Nursing
4. Outpatient specialty services
This transitional care assistance as described above is guesstimated by our case managers to be 4 patients/month – those patients who do not meet the criteria to go to any facility, thus not covered by insurance and yet cannot be discharged home.
Would additional funding change this number? How much money for Transitional Care would be "too much"? What is the mean/average support from LPCH for a child in Transitional Care?
We have had patients stay at the hospital from 1-90+days. In most of these cases insurance will not pay the stay at the hospital because the patient does not meet medical criteria, as such is ready to discharge. There are currently no funds to support this stay, thus for these cases the hospital would need to write off as bad debt. We can safely guesstimate about $10,000/night at the hospital (more or less depending on procedures, and acuity).
What is the range of time that a child typically spends in Transitional Care?
The average length of time the patient requires transitional care assistance will vary from patient to patient. Patient situations may be short-term or long-term, including palliative care. We may need a patient who needs at home medical teaching of some care management that can take 3 days of a home nurse going to do the education and approve appropriate management by the family at home, alternatively we have had instances where our patient may go home on 8/12/24 hour nursing for a year.
What is the mean cost of a 24 hour stay at LPCH?
We have had patients stay at the hospital from 1-90+days. In most of these cases insurance will not pay the stay at the hospital because the patient does not meet medical criteria, as such is ready to discharge. There are currently no funds to support this stay, thus for these cases the hospital would need to write off as bad debt. We can safely guesstimate about $10,000/night at the hospital (more or less depending on procedures, and acuity).
What is the cost of a transitional care facility stay overall for the patient?
The cost of transitional care assistance overall for the patient can vary depending upon the hours of care needed (e.g., 8, 12, or 24 hours/day). For instance, a skilled nursing facility can cost anywhere from $400-$500/day (low end) and provide 24 hour/day assistance. An LVN providing home nursing care can cost anywhere from $50-$70/day. For an 8 hour day, the cost would range from $400-$560/day. And, as Jody mentioned a transitional care facility can cost about $20,000/month, depending on care needed.
For transitional care assistance, funds would support patients needing some type of transitional care assistance/support. These are patients who do not meet sub-acute level of care to be discharged to a sub-acute facility (for our patients who meet criteria for sub-acute facilities these services are normally covered by insurance), but cannot be discharged home because the patient needs further care assistance. For example, patients identified as needing a targeted clinical intervention that may not be managed at home/have failed to be managed at home. The transitional care assistance options require much creativity, and most of the time would need to fall under the following options (although not limited to these):
1. Skilled Nursing Facility
2. Sub-acute facility
3. Home Nursing
4. Outpatient specialty services
This transitional care assistance as described above is guesstimated by our case managers to be 4 patients/month – those patients who do not meet the criteria to go to any facility, thus not covered by insurance and yet cannot be discharged home.
Would additional funding change this number? How much money for Transitional Care would be "too much"? What is the mean/average support from LPCH for a child in Transitional Care?
We have had patients stay at the hospital from 1-90+days. In most of these cases insurance will not pay the stay at the hospital because the patient does not meet medical criteria, as such is ready to discharge. There are currently no funds to support this stay, thus for these cases the hospital would need to write off as bad debt. We can safely guesstimate about $10,000/night at the hospital (more or less depending on procedures, and acuity).
What is the range of time that a child typically spends in Transitional Care?
The average length of time the patient requires transitional care assistance will vary from patient to patient. Patient situations may be short-term or long-term, including palliative care. We may need a patient who needs at home medical teaching of some care management that can take 3 days of a home nurse going to do the education and approve appropriate management by the family at home, alternatively we have had instances where our patient may go home on 8/12/24 hour nursing for a year.
What is the mean cost of a 24 hour stay at LPCH?
We have had patients stay at the hospital from 1-90+days. In most of these cases insurance will not pay the stay at the hospital because the patient does not meet medical criteria, as such is ready to discharge. There are currently no funds to support this stay, thus for these cases the hospital would need to write off as bad debt. We can safely guesstimate about $10,000/night at the hospital (more or less depending on procedures, and acuity).
What is the cost of a transitional care facility stay overall for the patient?
The cost of transitional care assistance overall for the patient can vary depending upon the hours of care needed (e.g., 8, 12, or 24 hours/day). For instance, a skilled nursing facility can cost anywhere from $400-$500/day (low end) and provide 24 hour/day assistance. An LVN providing home nursing care can cost anywhere from $50-$70/day. For an 8 hour day, the cost would range from $400-$560/day. And, as Jody mentioned a transitional care facility can cost about $20,000/month, depending on care needed.
