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From the Pride in the Inland Empire Series
Vencor Hospital System
Vencor is a publicly traded company that has been in operation since 1987 and at present owns 40 hospitals in the United States, six of which are in California (San Leandro, Sacramento, Los Angeles, Orange County, and Ontario). Vencor Hospital -Ontario is a 91 bed facility, located at 550 Monterey Ave., Ontario, California 91764. Vencor Hospitals are unique both clinically and financially.
Clinical Focus
Vencor Hospitals are designated as "long term acute care" facilities by HCFA. They are not sub-acute units or skilled nursing facilities. Vencor patients must meet acute care criteria and undergo routine CMRI review for appropriateness of care. The hospitals are JCAHO accredited and have standard credentialing requirements and peer review.
Most Vencor patients have some form of respiratory disease and require mechanical ventilation. Our goal with these patients is to obtain the highest possible rates of weaning and survival and to deal professionally with the complex ethical and psychosocial issues that are involved in their care. Most of these patients are admitted to Vencor from other hospital ICUs where they have usually been hospitalized for two to three weeks. They are usually malnourished with an average admitting albumin of 2.5 mg/dl, have single organ failure (usually COPD + emphysema with the original episode of respiratory failure precipitated by an infectious disease, cardiac event, or neurologic deterioration), and are often colonized or infected with resistant gram negative flora. About 10 percent of the respiratory failure admissions come with ET tubes, the rest have undergone tracheotomy prior to arrival.
Respiratory failure patients are admitted to an attending physician, Pulmonologist and Critical Care physician and most of the other clinical work is done by GI and ID consultants. Vencor has a high commitment to the technology involved in caring for these patients; the ventilators are all PB 7200s, the ICU is equipped with full monitoring capability, the Bicore monitor is used to assess weaning potential, indirect calorimetry is available, and telemetry and pulse oximetry are frequently utilized.
A smaller percentage of the census will have non-respiratory diseases that require on-going acute care, e.g., complex wounds, multiple medical problems that are too involved for subacute or SNF level care, or post operative conditions.
The average Vencor length of stay is approximately 45 days. Discharges are directed back to the referring institution and clinicians. The long length of stay provides for a different dynamic with families and allows for frequent opportunities to discuss the clinical issues with loved ones. There is a weekly patient care conference with physician invited involvement which is multi-disciplinary and provides an excellent opportunity to review the big picture with their staff.
As an acute care facility, Vencor has full lab, x-ray, pharmacy, PT, OT, speech, and respiratory therapy support. The Vencor Hospital l Ontario has 7 beds in ICU and 6 beds in DOU (Definitive Observation Unit). The remaining beds are Telemetry -Medical/Surgical. Vencor is on the cutting edge of cost efficiency as a system and utilization of x-ray, lab, and ICU is carefully monitored with feedback provided to the physician. The Hospital will contract out for expensive services that already exist in the community such as CT, nuclear medicine, and certain lab testing.
Other Aspects
Vencor Hospitals are exempt from the DRG payment mechanism by virtue of their "long term acute care" designation with HCFA. Physician billing at Vencor is exactly the same as it is at any other acute care hospital. Patients must be seen daily, H & Ps and Operative Reports must be dictated, and discharge summaries must be completed in a timely fashion.
Most admissions to Vencor come in via the Hospital's case management program. Physicians can refer their own patients to Vencor and follow them after becoming credentialed. A small number of admissions are direct from the office or from a local Emergency Room.
Despite all of the progress made in medical diagnoses and treatment, people are still struck down with catastrophic illnesses and complex body system failures. They and their families face difficult decisions, lengthy treatments, and uncertainty about eventual outcomes. Vencor Hospital -Ontario is dedicated to helping patients work through this process.
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