| Information
for Patients and Families
Following
an accident or illness, a person’s body and mind
may not function as they did before. At the Rehabilitation
Center, our purpose is to teach the mind, train the body,
and lift the spirit to restore as much self-reliance as
possible.
The
focus of our multi-disciplinary treatment team is to improve
self-care and Activities of Daily Living (ADL). Patients
work to relearn skills like getting dressed, handling
personal hygiene, and safety. Patients wear street clothes
and learn to be increasingly self-sufficient.
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|
The
20-bed unit provides 24-hour nursing care and is designed to
meet the needs of rehab patients. Semi-private rooms are large
and the entire floor encourages social activities, with a large
group dining and activity room, open visiting areas, and an
outdoor atrium for fresh air. All patient rooms are furnished
with telephones and a color television with cable channels.
The
daily routine includes occupational, physical, communication
and recreational therapies. Patients work on activities to increase
independence such as getting in and out of bed, bathing and
dressing, and walking or using a wheelchair.
Our
Commitment to You
|
The
scope of rehabilitation is comprehensive, goal-oriented,
and interdisciplinary. Goals during the coarse of treatment
focus on:
| · |
Achieving
maximum function |
| · |
Achieving
an acceptable quality of life |
| · |
Addressing
specific needs |
| ·· |
Becoming
an active participant in decision making |
| · |
Adjusting
to a changed lifestyle |
| · |
Promoting
an optimum state of wellness and preventing complications |
| · |
Returning
to the community |
|
 |
| Rehabilitation
focuses on the total patient, not just one aspect of the
disease process. Rehab nurses assist the patient in meeting
needs by acting as teachers, coaches, and advocates for
the patient. Rehabilitation is a collaborative practice
involving all professionals on the team. |
Multidisciplinary
Team Approach
·
Rehabilitation physicians
· Consulting physicians
· Rehabilitation nurses
· Physical therapists
· Occupational therapists
· Speech pathologists
· Therapeutic recreation specialists
· Social workers
· Psychologists
· Support staff
· Dieticians |
 |
Team
Conferences
Team conferences are held within the first week of admission
to develop an initial program plan. Team conferences will then
occur every week to assess progress. When it is time to be discharged
from the rehab unit, the team will meet once again to determine
final recommendations.
Family/Caregiver
Involvement
Families
and caregivers are highly encouraged to participate in
therapy sessions. Family/caregiver involvement is critical
to the patient’s success upon leaving the rehab
unit. An adult should supervise visiting children at all
times.
Average
Length of Stay
The average length of stay is 9 days. Length of stay is
determined by a number of factors including the ability
of the patient to participate in therapy sessions, the
potential to make significant improvement and supports
available upon discharge. Length of stay will be decided
after admission to the rehab unit.
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Discharge
It is important to think about discharge plans even before a
patient is admitted. Families should identify people who can
provide support (care, supervision, housekeeping, etc.) if necessary
when a patient is discharged. Although everyone is hopeful of
significant improvements after a stay on rehab, alternative
arrangements need to be considered in the event that a patient
does not make enough improvements to return to their prior living
situation. Alternative arrangements that may need to be considered
are moving in with a friend or relative; having a friend or
relative live with the patient; or consider moving to a different
home, assisted living facility or nursing home.
|
Admission
Criteria for Clinicians
Admission to the Inpatient Rehab Unit requires patients
to meet criteria developed by Medicare and private insurance
payers. Medicare encourages referrals from the following
list of diagnoses:
| 1. |
Stroke |
| 2. |
Spinal
cord injury |
| 3. |
Congenital
deformity |
| 4. |
Amputation |
| 5. |
Major
multiple trauma |
| 6. |
Fracture
of the femur |
|
|
| 7. |
Brain
injury |
| 8. |
Neurological
disorders |
| 9. |
Burns |
| 10. |
Active,
polyarticular rheumatoid arthritis, psoriatic arthritis
and seronegative arthropathies |
| 11. |
Systematic
vasculidities with joint inflammation |
| 12. |
Severe
or advanced osteoarthritis (osteoarthrosis or degenerative
joint disease)
| ·
|
Patients
must have severe osteoarthritis in at least 2 major
weight-bearing joints |
|
| 13. |
Certain
categories of hip and joint replacements
| ·
|
Extremely
obese patients with a BMI of at least 50 |
| ·
|
Frail
elderly with an age of 85 or greater |
|
The
patient being considered for admission may also have problems
in one or
more of the following areas:
· Mobility
· Bladder management
· Bowel management
· Pain
· Self-care
· Safety
Access
to the Inpatient Rehab Unit
| 1. |
Physician
referral to physiatrist |
| 2. |
The
patient must be medically stable as to participate in an
intensive interdisciplinary program. If diagnostic tests
are required, patients should have those completed in Acute
Care. This will avoid interference with Rehab therapy schedules.
If diagnostic tests are ordered while the patient is on
Rehab, the physiatrist is responsible for documenting the
reason and the amount of time lost in therapy during that
period. |
| 3. |
Patients
may be admitted to Rehab as long as there is an expectation
of the measurable improvement of practical value to the
patient within a reasonable time frame. At the time of Rehab
admission, patients are not able to live alone. |
| 4.
|
Patients
need to be involved in at last two disciplines – one
of which must be a therapy: physical therapy, occupational
therapy, speech therapy, prosthetics/orthotics, nursing,
social work, and psychology. The interaction must be coordinated
in a multidisciplinary fashion. |
| 5. |
Patients
must receive three hours of skilled therapy 5 out of 7 days.
If a medical complication limits participation, an equivalent
amount of combined therapy and other nursing intervention
related to the patient’s need for rehabilitation can
be substituted. |
| 6. |
An
Inpatient Rehab stay will be considered reasonable as long
as treatment cannot be provided in a less-intensive setting
due to the need for:
| ·
|
24-hour
nursing coverage |
| ·
|
Frequent
physician assessment and intervention due to significant
risk of rapid change in physical or mental status |
| ·
|
Specialized
equipment at such frequency and duration to make it
impractical to use the equipment on an outpatient
basis. |
|
Applicants
cannot be admitted to the rehabilitation program if any of the
following conditions exist:
| 1. |
Severe
cardiac limitations |
| 2. |
Extensive
decubitus or other extensive skin ulcers that would limit
the patient’s participation in a rehabilitation program |
| 3. |
Comatose
status |
| 4. |
Chronic
confusion or disorientation. |
| 5. |
Addiction
to narcotics or drugs unless related to recent medical problems |
| 6. |
Acute
illness |
| 7.
|
Severe
mental illness |
| 8. |
Conditions
requiring care that the program cannot provide because a
specific service is required or because of staff limitations |
| 9. |
Previously
treated at this facility, but had singed out AMA, unless
a member of the medical staff agrees to treat the patient
upon return to the facility |
Required
Paperwork for Admission
| 1. |
History
and physical |
| 2.
|
All
consults |
| 3. |
X-ray
reports |
| 4. |
Diagnostic
studies pertinent to patient condition, i.e.
| ·
|
Carotid
duplex |
| ·
|
MRI/MRA |
| ·
|
EEG |
| ·
|
EKG |
|
| 5. |
Lab
Tests
| ·
|
Protime |
| ·
|
Hematology |
| ·
|
Chemistry |
| ·
|
Culture
reports |
|
| 6.
|
PT,
OT, CR evaluations |
| 7. |
Demographic
information including financial information |
| 8. |
Current
medications |
| 9. |
Past
72 hours nurses notes, therapy updates and physician progress
notes |
| 10. |
A physician-to-physician
phone call |
Discharge
from the Rehabilitation Program
Patients will be discharged from the rehabilitation program
when the following occurs:
| 1.
|
The
patient has achieved his/her stated rehabilitation goals |
| 2. |
An
intensive, interdisciplinary treatment program is no longer
required and further progress toward established rehabilitation
goals can be achieved in a less intensive setting |
| 3. |
Additional
functional improvement is not anticipated |
| 4. |
The
patient’s functional status has not changed as documented
through two consecutive team meetings |
| 5. |
Medical
complications preclude an intensive rehabilitation effort |
| 6.
|
During
a trial evaluation period, the patient does not exhibit
the functional improvement that can be achieved within a
reasonable amount of time |
| 7. |
The
patient refuses to participate in an intensive inpatient
rehabilitation program |
Discharge
plans are initiated on the day of admission. The patient support
systems are identified and the discharge disposition as well
as an alternative discharge plan will be reviewed at the patient’s
first rehabilitation team conference.
Questions
or Comments
Terry Dahlstrom, Nurse Manager
Barb Murringer, Assistant Nurse Manager
Ann Montcalm, Admission Coordinator
Monday
– Friday Saturday – Sunday
1-800-562-9753 ext. 3171 1-800-562-9753 ext. 3190
