Growing and Serving


Rockcastle enhances resident care by adding dialysis and ambulance services, growing admissions and psychiatry teams

When many consider the growth of Rockcastle Regional over the years, they think in terms of capacity. Since the organization began specializing in the care of residents on mechanical ventilators in 1986, it has steadily expanded to the current total of 143. But at the individual level, a more significant type of growth is that in services offered to ensure that each resident gets the best care possible. This year has been a particularly good year for that kind of service growth, as the facility has added psychiatric care, a dialysis center, and a dedicated ambulance for transporting residents.


In the fall of 2019, Rockcastle Regional, in partnership with Dialysis Clinic, Inc., began offering kidney dialysis to its patients, including residents of the respiratory care center. The new service makes Rockcastle Regional one of the few places in the state equipped to administer dialysis to residents on mechanical ventilators. “Providing dialysis for our community, including our ventilator patients, has long been a goal of Rockcastle Regional,” said Stephen A. Estes, president and CEO. “For our ventilator patients in particular, dialysis enables us to provide a better continuity of care that reduces the need for transporting patients to other facilities.”

Dialysis is a treatment needed when a patient’s kidneys can no longer take care of the body’s needs. When kidneys fail, dialysis keeps the body in balance by removing waste, salt, and extra water to prevent them from building up in the body, keeping a safe level of certain chemicals in the blood, and helping to control blood pressure. Treatments typically occur three times a week, and each treatment may last three to four hours. Kidney failure is not uncommon among ventilator patients, most of whom are already medically fragile.

In the past, Rockcastle Regional residents who went into kidney failure had to be transported to another facility such as UK Healthcare. If the kidney failure was chronic, which is most often the case, the patient would not be able to return. Now, Rockcastle Regional has the capacity to continue serving those residents while also admitting new residents who are already receiving dialysis.

“This increases our capacity to serve a broader patient population,” Mr. Estes said. “So this continues to fulfill our mission of serving one patient at a time with the best possible quality of care, but it also accommodates future growth of our organization to serve more patients.”


Rockcastle Regional welcomed psychiatrist Dr. Kelsey Ladd to join its medical team. As the community’s first fulltime psychiatrist, she welcomed the opportunity to provide services to the respiratory care center residents in addition to outpatients. “I approach every patient as I hope someone would my family member or loved one,” Dr. Ladd said. “How would I want someone to care for my mother, grandfather, husband, or child? My goal is to provide the best care in a compassionate, patient, and empathetic manner.”

Dr. Ladd earned her medical degree from the University of Kentucky College of Medicine in 2014 and completed her residency in psychiatry from the University of Kentucky. “Psychiatric illnesses are some of the most common disorders in medicine,” Dr. Ladd said. “The resource is especially important for our residents, many of whom are under enormous emotional and physical stress. Not every patient will require the service of a psychiatrist, however it is essential that care be available, if needed.”

“Having a psychiatrist on staff is a valuable addition to our services,” said Mikhael Shaffer, director of social services. “It’s another way we are able to support our patients from a wholistic perspective.”

Dr. Ladd joins a team of counselors who serve Rockcastle residents, including Chelsen Larkey, LPCC; Jenny Collier, LCSW; and Brent Hasty, CSW.

New ambulance

Rockcastle Regional’s respiratory care center continued to expand its services in 2019 with the addition of a its own ambulance for transporting residents. The addition means that the respiratory care center, which historically has relied on other services for transport, will independently have the means to move new residents to the facility and take residents to and from out-of-town medical specialty appointments. “This gives us the flexibility to adapt to our residents’ needs,” said Tammy Brock, Rockcastle Regional’s chief nursing officer.

The $130,000 ambulance is staffed by a transport team consisting of a paramedic and emergency medical technician, who will be employees of Rockcastle Regional, and is specially equipped with additional oxygen capacity to accommodate patients who are on mechanical ventilators. It also features a power cot system for patient comfort and to protect staff from lifting injury.

“The investment in this ambulance means we are taking full ownership of the transportation process,” said Stephen A. Estes, president and CEO, “We think this will improve our organizational efficiency and timeliness, and we look for it also to have a positive effect on communication, which is so critical across the continuum of patient care.”

Admissions team grows

After 25 years as Rockcastle Regional’s sole admissions coordinator, Carolyn Browning was joined by teammates in 2019. In March, Debra Roberts, RN, BSN, joined Carolyn in a role that is the organization’s first point of contact with potential residents and their families. When Rockcastle Regional receives a referral, the admissions coordinator travels to the given healthcare facility to evaluate the patient. If the resident is appropriate for admission, then she coordinates with the referring facility to expedite the admission process.

The completion of the organization’s latest addition increased its capacity to 143 beds, creating the need for an additional coordinator. Covering most of Kentucky’s counties and the southeastern United States, Carolyn travels most days evaluating potential residents of the respiratory care center. Now the service area will be divided in two. Debra will take the area south of Rockcastle Regional, while Carolyn will cover all points north.

Angie Hansel also joined the admissions team in 2019 as a referral intake assistant. Angie, a 24-year employee of Rockcastle Regional, logs referrals serves as a point of contact when Carolyn and Debra are on the road. Debra began with Rockcastle Regional in 2006 as a floor nurse and most recently was a case manager/discharge planner for the hospital’s acute care wing.

“I love it,” Debra said of her new role, noting that within the last week, she had been in Alabama, Tennessee, and Bowling Green, Kentucky. “I really enjoy getting out and collaborating with the other facilities to make sure the patients get the appropriate care and their needs are met.”

She says she is still learning from Carolyn, whom she calls the “guru” of admissions for Rockcastle. For her part, Carolyn is glad to be working with a team. “It’s awesome to have them on board, and it’s a relief to know there’s someone else here who works day-to-day in the admissions process.” And she’s not surprised that Debra enjoys the job Carolyn has been doing for so long. “We get to meet new people, and we get to help people,” Carolyn said. “I enjoy getting to know the residents and families before they come to Rockcastle. In many ways I feel sort of like an ambassador for the organization.”