Concierge Director: Rosmery Garcia
Patient age: 83
Admission Date: 12/24/2025
Admitted From: Baptist Hospital-Miami
Discharge to: Home with Home Health
Reason for stay: Weak legs sent for rehabilitation
How did the patient hear about Coral Reef Subacute? Previous patient
Details of Experience:
Mrs. S was transferred to the Coral Reef community on December 24, 2025, from Baptist Hospital Miami after experiencing profound weakness that had significantly affected her condition. At the time of transfer, she had a diagnosis of acute respiratory failure with hypercapnia, requiring continued close monitoring and care. Her clinical picture was further complicated by underlying chronic illnesses, including acute-on-chronic diastolic (congestive) heart failure and chronic pulmonary disease, which added to the complexity of her treatment and overall prognosis.
Mrs. S is a returning patient to Coral Reef, who was previously very independent at home. Upon her arrival during this admission, she described her experience in the community during the first week as reassuring and comforting. Unlike her prior admission, which occurred under more uncertain circumstances, she expressed that arriving during the daytime and knowing what to expect significantly eased her anxiety. Although the hospital selected the facility for her transfer, she shared that she felt a sense of relief and even excitement upon recognizing familiar faces, which reassured her and helped her feel safe, valued, and embraced by those around her.
Within her first 48 hours, Mrs. S was assessed by the interdisciplinary team, including nursing and therapy services, to evaluate her current functional status and immediate care needs. During this time, she reconnected with several staff members she had met during her previous stay, including the Activity Aide, Natasha, her Therapist, Pablo, and familiar nursing staff such as Claudia, all of whom contributed to her sense of comfort and trust.
During her therapy evaluations, it was determined that Mrs. S required substantial to maximal assistance with bed mobility, transfers, and ambulation. Mrs. S can ambulate approximately 10 feet with maximal assistance at the time of admission. Based on these findings, her individualized care plan focused on improving strength, mobility, and functional independence. The goal was to help her return to the highest possible level of independence and safely transition back to her home environment.
During her second week, Mrs. S reflected on her progress and shared that, while she did not yet feel she had fully accomplished her goals, she valued the improvements she was making each day. She remained actively engaged in our therapeutic department, spending her free time on activities she enjoys, such as bingo, reading the newspaper, completing word searches in her room, playing card games, and painting her nails during activity spa days. These activities provided her with enjoyment, a sense of normalcy, and positive experiences throughout her stay.
Clinically and therapeutically, Mrs. S has made meaningful progress since admission. She now requires only setup and supervision during transfers and bed mobility, compared to maximal assistance at admission. She continues to maintain a moderate level of independence, which is very important to her, and she has been enthusiastic about returning home to her family. Her faith remains central to her life, and to support this, the community provided a portable oxygen concentrator, enabling her to attend church comfortably.
Reflecting on her stay, Mrs. S shared a heartfelt testimonial: “I want to thank the entire staff, especially the ones that worked closely with me—therapists and activities staff, as well as the doctors and nurses. If I had to come back, I would choose here!” She also expressed gratitude towards the staff and me for selecting her to participate in the case study, adding, “I truly love everyone.”
Overall, Mrs. S’s experience highlights both her functional progress and the positive, supportive environment. Ms. S is scheduled to return home on April 3, just before Easter, accompanied by one of our dedicated care partners. She will be going home with her son and daughter and will continue to receive assistance from a nurse, therapist, and home health aide to help maintain and further facilitate her independence. At the time of discharge, Mrs. S is walking 75 feet with the assistance of her walker and continues to demonstrate remarkable motivation and dedication to improving her physical strength and overall health.
We are proud of the progress she has made during her stay and are confident that, with ongoing support and her determination, she will continue to thrive at home. We wish Mrs. S comfort, strength, and many brighter days ahead, filled with good health and peace.
She will always hold a special place in our hearts, and we send our very best wishes as she transitions back home to her family.