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70-year-old female admitted to University City Rehabilitation and Healthcare Center from Penn Presbyterian Medical Center, where she initially presented after a fall. Patient found to have left impacted femoral neck fracture. Patient s/p left hip closed reduction and pinning with eventual conversion to left total hip arthroplasty by Dr. Derek Donegan. Patient is WBAT post-op. Hospital course complicated by anemia s/p 2units of PRBCs and UTI s/p antibiotic course. Past medical history is significant for diabetes, HTN, HLD, depression, anxiety, and CVA. Patient transferred to University City Rehab for continued medical optimization and ongoing therapy services.
Medication Management – Aspirin, Atorvastatin, Ezetimibe, HCTZ, sliding scale and prandial insulin, Lantus, Losartan, and Oxycodone PRN
Close Monitoring of Vital Signs including accu-checks Monitor Surgical Incision
Therapy Interventions: Followed closely by PMR provider, Natasha Williams, CRNP.
Goals: Patient’s goals were to regain her independence and return to prior level of function.
Initial Evaluation: Upon admission, she required Mod A for bed mobility and transfers. She also required assistance with self-care including Mod A for bathing, and Max A for toileting and lower body dressing.
Interventions: Comprehensive therapy program was developed consisting of physical and occupational therapy.
Discharge Evaluation: At discharge, she was Mod I for bed mobility and supervision for transfers and able to ambulate 300 feet with RW. She also regained her independence with self-care including supervision with bathing, dressing and toileting.
After a successful stay at University City Rehab, the patient was able to safely discharge home with support from Penn Medicine at Home. She will continue to be supported by her PCP, Dr. Chong Duk Kim in the community.
81-year-old female admitted to University City Rehabilitation and Healthcare Center from Thomas Jefferson University Hospital, where she initially presented for elective left total knee replacement due to end-stage primary osteoarthritis that failed conservative management. Patient s/p left total knee replacement by Dr. Scot Brown. Post-op she is WBAT and started on Aspirin for DVT PPX. Past medical history is significant for chronic bronchitis, HTN, HLD, GERD, anxiety, and prediabetes. Patient transferred to University City Rehab for continued medical optimization and ongoing therapy services.
Medication Management – Aspirin, Atorvastatin, Tizanidine, Pregabalin, Chlorthalidone, Meloxicam, Oxycodone PRN
Monitoring of Surgical Incision – cleanse with wound cleaner and leave OTA Close Monitoring of Vital Signs
Therapy Interventions: Followed closely by PMR provider, Natasha Williams, CRNP.
Goals: Patient’s goals were to get strong enough to go home.
Initial Evaluation: Upon admission, she required Min A for bed mobility and transfers. She was able to ambulate 50 feet with RW and standby assistance. She also required assistance with self-care including Min A for bathing, toileting, and lower body dressing.
Interventions: Comprehensive therapy program was developed consisting of physical and occupational therapy.
Discharge Evaluation: At discharge, she was Mod I for bed mobility, transfers and able to ambulate 300 feet with RW. With supervision, she was able to safely ascend/descend 20 steps. She also regained her independence with self-care including Mod I for toileting and upper body dressing along with set-up assistance for bathing and lower body dressing.
After a successful stay at University City Rehab, the patient was able to safely discharge home with support from Continuous Home Care. She will continue to be supported by her PCP, Dr. Mica Winchester in the community.
95-year-old male admitted to University City Rehabilitation and Healthcare Center from
Pennsylvania Hospital, where he initially presented with several days of dark stool and lethargy. Patient found to have hemorrhagic shock d/t bleeding duodenal ulcers. Hospital course c/b hypoxic respiratory failure secondary to heart failure s/p IV diuresis with eventual transition to oral Lasix. Patient maintained on supplemental oxygen with plan to wean as tolerated. Past medical history significant for CAD s/p PCI, sick sinus syndrome s/p PPM, COPD, diabetes, prostate cancer and recent femur fracture s/p cephalomedullary nail c/b acute PE on anticoagulation. Patient transferred to University City Rehab for continued medical optimization and therapy services.
Medication Management – Lasix, Bicalutamide, Atorvastatin, sliding scale insulin, Flomax
Close Monitoring of Vital Signs including Accu-Checks and pulse ox
Ensure Adequate Nutrition – initially patient was tolerating CCHO pureed texture with nectar consistency liquids with nutritional supplements. Patient actively worked with speech therapy and diet was advanced as tolerated. At the time of discharge, he was tolerating CCHO diet with mechanical soft texture and thin liquids with supplemental Ensure Plus, Mighty Shake and Magic Cup.
Patient was followed closely by our Pulmonologist, Dr. Michael Korman and our full-time in-house Respiratory Therapist. Patient initially on 5L O2 via NC. While in-house, he was successfully weaned to 2L via NC. Patient maintained on Advair.
Patient actively participated in physical and occupational therapy. At discharge he required supervision for bed mobility and Min A for transfers. With Min A he was able to complete bathing and lower body dressing. He was contact guard assist for upper body dressing.
After a successful stay at University City Rehab, the patient was able to return home with support from family and Penn Medicine at Home. He will continue to be support by his PCP, Dr. Ngoc An Phan in the community.
64-year-old male admitted to University City Rehabilitation and Healthcare Center from The Hospital of the University of Pennsylvania, where he initially presented from outside hospital as a transfer for psychiatric evaluation in the setting of a subacute delusional episode with recurrent and persistent Enterococcus faecalis infection. Psych consulted, no current SI or plan. Plan for follow up as needed. ID consulted for persistent Enterococcus faecalis. Plan to continue suppressive doxycycline. Past medical history significant for ICM HFrEF s/p heartmate 2 LVAD placement c/b hemorrhagic CVA, recurrent E. Faecalis bacteremia and Enterobacter PNA, pHTN, diabetes, hypertension, hyperlipidemia, CAD s/p PCI to LAD and LCx and CKD. Patient was transferred to University City Rehab for long-term placement.
Medication Management – Amlodipine, Amiodarone, Atorvastatin, Propranolol, Sildenafil, Doxycycline
LVAD Dressing and Driveline – weekly sterile dressing changes, observe driveline insertion site for s/s infection and damage
LVAD Management – check LVAD numbers q12hr including MAP via doppler, complete LVAD system controller checks q12hr
While at University City Rehab, the patient demonstrated impaired balance and endurance. An individualized therapy plan was developed including physical therapy. He actively participated in physical therapy while working on pacing and endurance. Currently, he is at a supervision level for transfers and Mod I for bed mobility and ambulation 500 feet with RW.
Patient is doing great and feels at home at University City Rehab
