Does anyone here work at SNF, REHAB, LTAC as Hospitalsits as a side gig? If so, could you tell us how your daily round is like? What to do and what notes to write? What to look for and when to send pt back into acute ER? I'd appreciate it !!!
Correct me if im wrong, but im fairly certain USC guy is not working at an Ltac but a Snf.
Ltacs (long term acute care) are more like a mini hospital and patients there need to be seen daily because of day to day adjustments (vent weaning, wound care etc). Patients there typically have complex medical issues.
Long term care at a SNF is for patients that live at the nursing home (ie not there for rehab), and are usually medically stable.They are seen once a month(ish) for a "check up" type of visit. This frequency is likely a medicare rule. If acute issues arise (ie pt has a cellulitis, pna, etc), then the pt would be seen more often depending on the situation and if warranted transfered out. Its sort of like primary care pcp visits; except the bare minimum is a visit once every 4-6 weeks.
Physicians at the rehab site provide medical oversight to their rehab stay, but again these patients are medically stable (hopefully). The doctors documentation is likely required by medicare/insurance to justify the need for rehab stay vs discharge home.
If you are a resident in IM im sure you will have a geriatrics rotation where you spend a portion at your time at the snf seeing patients for the routine visits and for the acute issues.
How much do you make from that per year if you don't mind sharing?I have 30-40 patients at my local SNF at any given time. Most are long term care, 5-10 in the subacute rehab. I see the long term folks every 6-8 weeks; the rehab people every week unless they are having problems (maybe they didn't finish diuresing are the hospital and need further titration).
I write a regular soap note and bill 99308-99310