A family-focused long-term care residence
Once the completed residence passes all inspections, the licensing will be finalized, and then we will be ready to consider admissions. The admissions process for prospective residents begins at the county level, and families can apply directly to Washington County Community Services. The applicant is screened by a public health nurse through the MNChoices or other local county provider, who will notify the Granite House admissions team if he or she is a good candidate. The admissions team will consist of the Executive Director (a Registered Nurse), our Administrative Co-ordinator (a Certified Medical Assistant or Licensed Practical Nurse), and a physician (either neurologist or general practitioner). If the admissions team feels that Granite House could meet the needs of this applicant, the county will arrange for a face-to-face meeting between the applicant (with his or her family or guardians) and the admissions team at the facility. The applicant’s family will consider the facility, staff, and services available, and the admissions team will consider the admissions criteria and ability to meet this person’s needs. Placement requires a mutual agreement between all parties, according to Minn. Rule §9555.5605.
Where are the residents coming from?
Our main referral source is Red Wing Healthcare, a long-term care facility that offers a specialized program in brain injury recovery. Their patients have commonly been discharged from hospitals when they have become medically stabilized and no longer need sub-acute care, but at the same time have not yet emerged to full consciousness.
After about a year post-injury, the likelihood of full emergence of consciousness is very low, so even Red Wing will discharge patients to long-term care unless the family is prepared to care for them. These are the families who need another alternative. They may be in long-term care when they come to us, or may be at home where the family cannot care for them any longer. We have been advised by several sources--trauma centers, rehab facilities, and hospitals--that we would be able to find enough patients to fill our beds, most likely more than we can serve.
Causes of traumatic brain injury could be car
accidents, blows to the head, sports injuries,
falls or accidents, or physical violence.
Causes of acquired brain injury include:
poisoning or exposure to toxic substances,
infection, strangulation, choking, or drowning,
stroke, heart attacks, tumors, aneurysms,
neurological illnesses,or abuse of illegal drugs.
Our residents are all non-ambulatory, non-verbal, incontinent, and may either eat softened foods and/or have a G-tube for administration of medications and liquid nutrition. They need maximum assistance with all activities of daily living (ADL's), including full assist with motorized transfers between bed and wheelchair.
Our admission criteria have been developed to include adults age 18 and over who may have spent at least a year post-onset of injury in sub-acute and other residential facilities where aggressive coma stimulation, medication, and physical therapies are prescribed. After one year, the recovery potential for patients in a minimally conscious state is very low, and we establish our criteria this way to insure that every individual has at least had every chance for the best outcome possible. Our residents will have already reached the last phase in the aggressive coma stimulation programs offered by facilities such as Bethesda Rehabilitation Hospital in St. Paul and may already be in a long-term care facility, with or without a Brain Injury program.