Patients Age: 84
Admission Date: 12/8/16
Admitted From: HVHC
Discharge Date:
Discharged To:
Length of Stay: 30+ days
Reason for stay: Tracheotomy weaning; Short Term Rehab to safely ambulate on level surfaces up to 200 feet; increase in functional transfers with Modified Independence; bed mobility function without use of siderails to enable getting in and out of bed; safely perform ADL tasks, including toileting and hygiene/grooming.
How did this resident hear about The Emerald Peek? The patient was referred to the facility through case management at the hospital.

Maria was admitted to The Emerald Peek with the following diagnoses: Heart failure, Dyspnea, Gait and Mobility abnormalities, Muscle wasting and atrophy. Maria lived independently in the community prior to admission and the discharge plan is to return her home. Her goals are to return home and return to assisting her family at the family’s farmer’s market. The dual priorities are to wean her off of her trach as well as increase mobility and ADL independent function. For trach weaning, 14 days after admission, initial testing of the capping began. By 12/30, Maria was on a daily 3 hour capping schedule and as of 1/5/17, Maria’s capping schedule is 3 hours on, 3 hours off. Decannulation is planned for end of January. For PT and OT, the focus has been on increasing mobility and ADLs, enabling Maria to participate in life as fully as she did prior to her incident.

Here are the resident’s baseline measurements and goals achieved during stay:

Bed Mobility
Baseline: Modified assistance
Current Achievement: Stand By Assist (limited assistance)

Baseline: Modified assistance
Current Achievement: Contact Guard Assist (limited assistance)

Mobility during ADLs
Baseline: Total dependence
Current: Modified Independent

Baseline: Maximum assistance
Current: Contact Guard Assist (limited assistance)

Baseline: Maximum assistance
Current: Set up with no assistance

Baseline: 5 feet with max assistance
Current: 100 feet with limited assistance

As of today, Maria is on track to return home to her family sooner than initially expected, helping her family and returning to her beloved community.