A common bottleneck to the efficient flow of patents into and out of the ICU is the inability to transfer chronic ventilator patients off the unit because there are not enough ventilator beds in other settings. One hospital solved this problem by partnering with an unaffiliated nursing home. The nursing home was able to open a ventilator unit because the hospital assigned an intensivist to serve as a part-time medical director for the unit. This helped improve flow out of the ICU and provide predictable income for the nursing home, and also resulted in high-quality, lower-cost care for the patients.