Stephanie Santos, age 62, was admitted to Carolinas ContinueCARE Hospital at University from Atrium Blue Ridge. She was originally admitted to Blue Ridge with shortness of breath and a fever. She was diagnosed with COVID-19 and acute respiratory failure.

Situation:
At Atrium Blue Ridge Mrs. Santos initially required intubation and was able to be extubated within a week. Unfortunately, she had to be re-intubated with worsening respiratory failure and found to have pneumonia. During her 32-day stay at Blue Ridge, she had a tracheostomy and peg tube placed, was treated for MSSA pneumonia and received convalescent plasma. After receiving her trach and peg, Stephanie was transferred to our LTACH for vent weaning and management of her other comorbid conditions including seizure disorder, anemia and lupus. Prior to Ms. Santos’ admission to Blue Ridge, she resided at a SNF for more than a month. Prior to that, she lived with her brother, her guardian and caregiver. She has a developmental delay and went to Adult Day Care daily.

Solution:
During her admission and treatment at Carolinas ContinueCARE Hospital at University, Ms. Santos was followed by our hospitalist, pulmonology, dietician, wound care nurse, wound care NP, physical, occupational and speech therapy.

Results:
During Ms. Santos’ 38-day stay at Carolinas ContinueCARE Hospital at University, she was able to wean from the vent and trach and was decannulated, passed a swallow evaluation, started on a regular diet, and progressed with therapy to limited assistance with wheelchair mobility. Her mentation returned to her previous level of cognitive status and she was out of bed and sitting in the chair coloring daily. Ms. Santos
was discharged to a sub-acute rehab facility near her home to be closer to her brother with the goal of returning home with him