Article Summary

Dialysis patients often face unique challenges after a hospital stay because they require ongoing kidney treatment while recovering from illness, injury, or surgery. Learn why placement can be difficult and how coordinated post-acute care can help support recovery.

For many older adults, a hospital stay marks the beginning of a longer recovery journey. After surgery, illness, or a medical setback, patients often transition to a rehabilitation or skilled nursing facility to regain strength and continue healing.

For patients with kidney disease who require dialysis, that transition can be considerably more complicated.

Dialysis treatment does not pause during rehabilitation. Most patients require treatment multiple times each week, creating unique challenges for discharge planners, healthcare providers, patients, and families trying to coordinate the next phase of care.

Why Placement Can Be Difficult

When a patient needs both skilled nursing or rehabilitation services and ongoing dialysis treatment, placement options can become more limited.

Many post-acute care facilities do not offer dialysis on-site. As a result, patients often need to travel to an outside dialysis center several times each week while simultaneously participating in rehabilitation and receiving skilled nursing care.

These arrangements can create logistical challenges for healthcare providers and families alike. Transportation must be coordinated, treatment schedules must align with therapy sessions, and multiple care teams often need to communicate across different organizations.

For older adults recovering from hospitalization, managing care across multiple locations can add complexity during an already difficult time.

The Importance of Coordinated Care

Many healthcare professionals believe dialysis patients benefit from care models that coordinate rehabilitation, nursing services, physician oversight, and dialysis treatment as part of a unified care plan.

Dialysis can affect energy levels, fluid balance, blood pressure, and overall endurance. These factors often influence a patient's ability to participate in rehabilitation and other aspects of recovery.

When care teams work closely together, they can communicate more effectively, coordinate schedules, and adapt treatment plans based on a patient's changing needs. This level of coordination can be especially valuable for medically complex patients transitioning from the hospital to post-acute care.

A New Approach to Post-Acute Dialysis Care

To help address these challenges, United Hebrew recently opened an advanced Dialysis Den on its New Rochelle campus.

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The new service brings dialysis treatment directly to the campus, allowing eligible residents and patients to receive treatment in the same environment where they receive rehabilitation, skilled nursing care, and other supportive services.

The Dialysis Den features four treatment bays and is staffed by registered nurses. Care is coordinated with United Hebrew's interdisciplinary team, and patients benefit from on-campus oversight by a board-certified nephrologist affiliated with Montefiore New Rochelle Hospital.

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For patients and families, this integrated approach may help reduce the burden of coordinating care across multiple locations while supporting continuity of care throughout the recovery process.

"Historically, patients who required both rehabilitation and dialysis often had to leave campus multiple times each week for treatment," said Winston Loza, Director of Rehabilitation at United Hebrew. "Having dialysis available on-site creates new opportunities for coordination between our rehabilitation, nursing, and medical teams while allowing patients to remain in a single familiar care environment."

Who May Benefit from On-Site Dialysis?

The Dialysis Den is designed to support a range of patients, including:

• Individuals recovering from surgery or hospitalization who require dialysis alongside rehabilitation

• Patients transitioning from the hospital who need both skilled nursing care and ongoing renal treatment

• Long-term residents with chronic kidney disease who require dialysis as part of their ongoing care

• Higher-acuity patients whose medical complexity may make placement more challenging

Questions Families Should Ask

If your loved one requires dialysis and is facing a hospitalization or transition to post-acute care, there are several important questions to ask when evaluating care options:

• Is dialysis provided on-site, or will transportation be required?

• How do the dialysis, nursing, and rehabilitation teams communicate with one another?

• Is a nephrologist involved in the patient's care plan?

• How are treatment schedules coordinated with rehabilitation services?

• What experience does the facility have caring for medically complex patients?

Understanding how care is coordinated can help families make informed decisions during a challenging time.

Looking Ahead

As healthcare continues to evolve, providers are exploring new ways to deliver specialized services closer to where patients live and recover.

The opening of the Dialysis Den reflects United Hebrew's ongoing commitment to expanding clinical services that support older adults with increasingly complex medical needs. By bringing advanced care services directly to campus, United Hebrew aims to help residents and patients access the support they need while remaining in a familiar and coordinated care environment.

To learn more about the Dialysis Den or discuss a referral, contact Grace Ferri at 914-636-6565 x107 or gferri@uhgc.org.

Frequently Asked Questions

What happens if a dialysis patient needs rehabilitation after a hospital stay?

Many dialysis patients transition to a skilled nursing facility or rehabilitation center following hospitalization. Because dialysis treatments must continue several times each week, patients often need a care setting that can accommodate both rehabilitation and ongoing kidney treatment.

Why is it difficult to place dialysis patients after hospitalization?

Placement can be challenging because many post-acute care facilities do not offer dialysis services on-site. Patients may require transportation to an outside dialysis center multiple times each week while also participating in rehabilitation and receiving skilled nursing care.

What is on-site dialysis?

On-site dialysis allows patients to receive dialysis treatment within the same facility where they live or receive rehabilitation and skilled nursing services. This eliminates the need for frequent transportation to an outside dialysis center and improves coordination among care teams.

Can a patient receive rehabilitation and dialysis at the same time?

Yes. Many patients recovering from surgery, illness, or hospitalization require both rehabilitation and ongoing dialysis treatment. Coordinating these services is an important part of post-acute care planning.

What questions should families ask when evaluating a rehabilitation or skilled nursing facility for a dialysis patient?

Families should ask whether dialysis is available on-site, how care teams communicate with one another, whether a nephrologist is involved in care planning, how treatment schedules are coordinated with rehabilitation services, and what experience the facility has caring for medically complex patients.

Who may benefit from on-site dialysis?

On-site dialysis may benefit patients recovering from hospitalization, individuals requiring both rehabilitation and dialysis, long-term care residents with chronic kidney disease, and medically complex patients who need coordinated clinical services.

Does United Hebrew offer on-site dialysis?

Yes. United Hebrew's Dialysis Den provides on-site dialysis treatment as part of its comprehensive senior care campus in New Rochelle. The service is integrated with skilled nursing, rehabilitation, and physician oversight to support patients with complex medical needs.

How can I refer a dialysis patient to United Hebrew?

Healthcare professionals, discharge planners, social workers, physicians, and families can contact Grace Ferri at 914-636-6565 x107 or gferri@uhgc.org to discuss admissions, referrals, or eligibility for the Dialysis Den.

After Hospitalization, Sub-Acute Care is Essential

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After Hospitalization, Sub-Acute Care is Essential

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