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Introduction: BRH is a 105-bed LTAC hospital network that serves as a regional weaning center, accepting chronically critically ill (CCI) patients transferred from the ICUs of hospitals in southern California. Herein we report updates to patient mortality and 12-month post-discharge survival from our Ventilation Outcomes Database (VOD). We also provide a perspective comparison analysis for three distinct time periods. Methods: Comparison of analysis of three time periods from the Ventilation Outcomes Database (VOD). VOD data were collected by trained personnel from transfer records and BRH medical records. Successful weaning was defined as ventilator independent for > 7 days for earliest cohort; weaning outcomes scored at discharge for latter two cohorts. Social services and discharge planning records, and Social Security Death Index determined post-discharge survival. Pre-morbid functional status was determined using the Zubrod Score (0 = Fully active to 4 = Bedridden with no self-care). Zubrod scores of 0-2 were deemed "good" functional status; scores of 3-4 were "poor" functional status. Results: 274 patients were admitted from 5/1988-6/1990. For this cohort of patients weaning outcomes were: 53.3% weaned, 16.8% remained ventilator-dependent, 29.9% died. Discharge disposition for the 192 live discharges: 42.7% home, 52.6% to extended care facilities (ECFs), 4.7% transferred to short-term acute care hospitals. 12-month post-discharge survival was 21.3%. 186 patients were admitted from 3/1/2002-2/28/2003. For this cohort of patients weaning outcomes were: 49.5% weaned, 21.5% remained ventilator-dependent, 29.0% died. Discharge disposition for the 132 live discharges: 22.7% home, 63.6% to ECFs, 13.6% transferred to short-term acute care hospitals. 12-month post-discharge survival was 31.0%. 563 patients were discharged from 1/1/2010-12/31/2011. For this cohort of patients weaning outcomes were: 52.0% weaned, 36.9% remained ventilator-dependent, 11.1% died. Discharge disposition for the 501 live discharges: 12.6% home, 75.6% to ECFs, 11.8% transferred to short-term acute care hospitals. 12-month post-discharge survival was 60.5%. For the most recent cohort of patients, survivors at 12-months post-discharge: age 73.5 [22-101] years, gender 49% male, weaned 76%, pre-morbid location home 74%, "good" pre-morbid functional status 54%. Conclusions: This is an interesting look at three distinct time period "snapshots" over two decades of post-ICU mechanical ventilation at a single facility. There are significant trends toward increasing ventilator dependency with a corresponding decrease in mortality; weaning success remained largely unchanged. Increased discharge to ECF is therefore not surprising, as fewer weaned patients are also discharged directly home. The increase in 12-month post-discharge survival is striking. Weaning from PMV and pre-morbid location of home appear to correlate with 12-month post-discharge survival. Efforts to determine patient location, and airway and ventilator status at this time point, with corresponding assessment and interpretation of functional status and quality of life in these survivors are particularly important challenges.