I recently discharged perhaps my most challenging and critically ill patient in the past ten years to Signature HealthCARE at The Courtyard in Marianna, Florida.  This patient was a brittle and notoriously non-compliant Type 1 Diabetic who had been in the hospital or an LTAC (long term acute care) for the previous three months.

During these lengthy admissions, this patient underwent four different surgeries, two different life threatening episodes of respiratory failure, and one complete cardiac arrest.  As a result, the patient was left with a large, high output enterocutaneous fistula that was impossible to manage, even with a wound vac.  In addition, the patient required long-term TPN (total parenteral nutrition) and octreotide therapy.

I saw the patient today for the first time since discharge and I was amazed!  He looked “normal” and healthy for the first time in over five months.  His wound vac had been minimized to a simple dressing as his enterocutaneous fistula had almost disappeared.

The care he has received at Signature HealthCARE at The Courtyard has been absolutely outstanding, and I am most grateful to the staff for all the hard work they have done to create such an amazing recovery.


Dr. Steven Spence, MD

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