OVERALL TABLE OF CONTENTS Rehabilitation Hospital of Fort Wayne 2 Meet the Medical Director 3 Frequently Asked Questions 4 What to Expect at Rehabilitation Hospital 5 Patient Satisfaction 6 Rehabilitation Terms 6 Stroke Rehabilitation Program 7 Comprehensive Inpatient Medical Rehabilitation Program 8 Special Diagnosis: Brain Injury 9 Special Diagnosis: Spinal Cord Injury 9 Special Diagnosis: Amputation 9 Driver Rehabilitation Program 10 MISSION The Rehabilitation Hospital of Fort Wayne is dedicated to providing individualized care for patients and families while rebuilding lives in a compassionate environment. ACCREDITATIONS The Rehabilitation Hospital of Fort Wayne is accredited by two organizations. The first is The Joint Commission, which is responsible for evaluating and accrediting hospitals that voluntarily submit for inspection using specific standards for quality and safety. The second organization is the Commission on Accreditation of Rehabilitation Facilities (CARF). CARF accredits organizations based on quality of care and services and values dedication to continuous quality improvement. CARF-accredited programs represent the gold standard in rehabilitation facilities. Rehabilitation Hospital is licensed by the Indiana State Department of Health and is Medicare approved.
458 PATIENTS IN 2014 12 77 % Rehabilitation Hospital of Fort Wayne The Rehabilitation Hospital of Fort Wayne is the region s only hospital dedicated solely to physical medicine and rehabilitation. The acute needs of adults and children age 14 and older who have experienced a disabling injury or illness are treated at the 36-bed comprehensive rehabilitation facility. The 49,000-square-foot, free-standing hospital offers private and semi-private rooms, a large therapy gym, an activities-of-daily-living area and a transitional living apartment. Additional features include an outdoor mobility courtyard with accessible gardens; a heated indoor therapy pool with lift-assist entry; an overhead track and harness system that allows patients to walk or practice balance activities without the fear of falling; a private therapy room with active video games; and large, easy-access bathrooms. Physical, occupational and speech therapists provide therapy services to help patients regain lost functional ability a minimum of three hours a day, five days a week. Additional sessions are provided on weekends, as needed. Therapy may be spread out 15 hours over seven days, if necessary. An individualized treatment plan is developed for each patient. Patients undergo therapy in a structured and safe environment that allows them to set and meet goals, increase their thinking and communication skills, gain greater physical endurance and become more confident and independent in activities such as dressing, eating and walking. Rehab physicians visit patients at least three times per week, and other specialists also follow patient progress, based on patient need. Registered nurses, including many who have rehabilitation certification, provide care and education 24/7. Other members of the interdisciplinary care team include a clinical psychologist who helps patients deal with emotional and cognitive disability-related issues, and case managers, who coordinate team efforts and after-discharge planning. UNPLANNED DISCHARGE TO ACUTE HOSPITAL 10 % CHOOSING REHABILITATION HOSPITAL I HOW TO REFER } Ask a social worker or case manager for a referral } Ask a physician for a referral } Call (260) 435-6121 and request an evaluation 2
MEET THE MEDICAL DIRECTOR Heidi Lang, DO,** a Lutheran Medical Group physician, was named medical director of the Rehabilitation Hospital in July 2014. In addition to her duties as medical director, Dr. Lang provides full-time physician coverage and manages the intensive care of Rehabilitation Hospital s patients, seeing most patients five times per week. Dr. Lang joined LMG as an internal medicine physician in July 2002. She served in that capacity for 10 years before joining the hospitalist team at Lutheran Hospital* in 2012. Dr. Lang began her career as an internist in Coldwater, Mich., in 1989. DID YOU KNOW? Rehabilitation Hospital provides full-time physician coverage a minimum of five days per week. That s just one mark of distinction at Rehabilitation Hospital. Dr. Lang received a bachelor s degree from the University of Notre Dame in South Bend and a doctorate in osteopathic medicine from the New York College of Osteopathic Medicine in Old Westbury, N.Y. She completed a rotating internship at Michigan Osteopathic Medical Center in Detroit and an internal medicine residency at Providence Hospital in Southfield, Mich. Dr. Lang, who is board certified in internal medicine, is a member of the American Osteopathic Association and the American College of Osteopathic Internists. PROGRAMS Comprehensive inpatient medical rehabilitation program Stroke specialty program Driver rehabilitation program CONDITIONS TREATED Stroke Neurological disorders Traumatic brain injury Trauma injuries Spinal cord injuries Acute and chronic diseases Amputations Back and neck injuries Cardiac and vascular disorders Fractures General weakness and debility Joint replacements Multiple sclerosis Orthopedic disorders Pain SERVICES Rehabilitation Hospital Nursing Physical, occupational, speech and respiratory therapy Case management/social work Dietary Discharge planning Nutritional counseling Clinical psychology Assistive technology Lutheran Health Network Rehabilitation physician Physician specialty consultations Dietary Laboratory Pharmacy Radiology Diabetes education Assistive technology Pastoral care Wound care Intravenous therapy Contracted Dialysis (hemo and peritoneal) Orthotics and prosthetics Additional services available on a consulting basis. 3
Frequently Asked Questions HOW DO I KNOW IF I AM ELIGIBLE FOR SERVICES AT REHABILITATION HOSPITAL? The first step is to contact your case manager or social worker and ask him or her to make a referral to Rehabilitation Hospital for an evaluation. An evaluation can also be requested by a patient or family member by calling the admissions office at (260) 435-6121. A nurse liaison from Rehabilitation Hospital will evaluate you to see if you meet admission guidelines based on Medicare or your insurance guidelines. A physician will also review your evaluation to determine appropriateness for admission. CAN I SCHEDULE A TOUR OF REHABILITATION HOSPITAL TO SEE IF IT IS RIGHT FOR ME OR MY LOVED ONE? Yes! Please call the admissions office at (260) 435-6121 to make arrangements to tour the facility. WILL I BE ABLE TO TOLERATE AN INTENSIVE REHABILITATION PROGRAM? Our program is designed to provide three to five hours of therapy a day at least five days a week. For some patients, the 15 hours of therapy may be spread out over seven days. In either case, the program is tailored to meet each patient s unique needs. Studies show that early intensive therapies result in better outcomes. WILL I HAVE THERAPY ON THE WEEKEND? The program is designed to provide at least three hours of therapy per day at least five days per week. Some patients may have medical tests or procedures that limit therapy time during the week. To ensure each patient receives the full benefits of the program, lost time may be made up over the weekend. Most patients have weekend therapy at some point during their stay. The need for weekend therapy is based on individual need and the interdisciplinary team s recommendation. CAN MY LOVED ONE WITH ME AND PARTICIPATE IN MY THERAPY? We encourage family and caregiver participation in the rehabilitation process. This means family members and caregivers are encouraged to stay and help patients adjust to their new environment. Family members and caregivers are encouraged to help patients complete the training required to ease back into living at home. There are also times when patients may need a more focused approach without distractions. The interdisciplinary care team will help make this determination. WHEN CAN I GO? Each patient s diagnosis and functional progress varies. The interdisciplinary team will complete an initial evaluation and work with patients to develop treatment goals and determine an estimated discharge date. The team will meet weekly to make adjustments to the plan based on patient progress. Just before discharge, the case manager and nurse help coordinate additional care needs, such as physician appointments and ongoing therapy. 4
What to Expect at Rehabilitation Hospital The first few days of your stay at Rehabilitation Hospital are when the team gets to know you and your preferences. Your first two days may look something like this: DAY 1 } Early to late afternoon arrival } Nursing assessment } Tour of facility } Initial visit with physician, therapist and case manager, depending on their availability DAY 2 } Evaluation by rehab physician, if not performed Day 1 } Evaluation by case manager, if not performed Day 1 } Evaluations by physical and occupational therapists } Evaluation by speech therapist, if needed } Ongoing nursing assessment } Meeting with registered dietitian } Meeting with clinical psychologist, if needed TYPICAL SCHEDULE At Rehabilitation Hospital, we do our best to make your schedule as close to a normal day as possible. 6 8 a.m. Bathe and dress for the day Early occupational therapy session (by preference) 8 8:30 a.m. Breakfast in the Gallery Café Speech therapy session 8:30 a.m. noon Morning therapy sessions (physical, occupational and speech therapy) Noon 1 p.m. Lunch at the Gallery Café and rest or socialize 1 4:30 p.m. Afternoon therapy sessions 4:30 6 p.m. Rest and dinner at the Gallery Café 6 10 p.m. Late occupational and/or physical therapy sessions (by preference) Rest, socialize and get ready for bed DISCHARGE CRITERIA Patients are discharged or transitioned to a different level of care when: } The patient has achieved the established functional rehabilitation goals. } The patient has care needs exceeding the acute rehabilitation level of care. } The patient has reached a functional plateau and the determination has been made that further progress is unlikely in a reasonable timeframe. } The patient no longer needs at least two therapy services to increase functional performance. } The patient no longer requires 24-hour medical or nursing supervision/treatment. } The patient requests discharge. } The patient and/or support system are no longer willing to be active participants in the program. 5
PATIENT SATISFACTION Rehabilitation Hospital earned an Excellence through Insight Award for Overall Patient Satisfaction in 2012, 2011 and 2009. Awarded by HEALTHSTREAM EXCELLENCE THROUGH INSIGHT AWARD Rehabilitation Hospital was awarded this honor for its commitment to excellence in patient care. To qualify for an award, a hospital must have been a patient satisfaction-tracking client of HealthStream, scored in the 75th percentile or higher and surveyed a minimum of 100 patients. Rehabilitation Hospital was chosen for receiving the highest ratings in overall patient satisfaction from among HealthStream s clients, as well as for exceeding industry standards. 2012 OVERALL PATIENT SATISFACTION 2014 Overall Patient Satisfaction 85 percent of patients would definitely recommend Rehabilitation Hospital of Fort Wayne The therapy is intense, but that s good. I have rehabbed at other hospitals where they only do one half hour of physical therapy in the morning, and then you are done until the next day. At Rehabilitation Hospital, you do a total of three hours a day, so you get better faster. From the nurses to the technicians to the physical therapists, everyone was fantastic. They let you know that their goal is to get you home as soon as possible. REHABILITATION TERMS CERTIFIED BRAIN INJURY SPECIALIST the physical space and make recommendations that will A clinician with advanced knowledge of brain injury evidenced allow the patient to safely return home. by clinical experience and completion of a certification examination as well as annual education. INTERDISCIPLINARY TEAM A team of healthcare professionals that coordinates efforts CERTIFIED REHABILITATION REGISTERED NURSE (CRRN) to reach a common patient goal. A registered nurse with at least two years of experience in RANCHO LOS AMIGOS SCALE rehabilitation who has demonstrated advanced rehab An evaluation scale that identifies patterns of recovery knowledge by passing a certification examination and for people with a brain injury. maintaining certification. COMMUNITY RE-ENTRY A therapeutic outing into the community designed to return patients to their prior level of function. EVALUATION The process in which therapists visit patients home to assess Rehabilitation Hospital accepts funding from a variety of sources, including private insurance, Medicare, Medicaid, HMO/PPO and self-pay. Case managers are available to help the uninsured apply for funding assistance. Patients are responsible for all deductibles and co-pays at the time of service unless prior arrangements have been made. Sources: UDS-PRO Standard Facility Report, Volume 28, Quarter 4, Jan. 2014 Dec. 2014; 2014 Quarterly Data, HealthStream Data Research 6
STROKE REHABILITATION PROGRAM OUTCOMES 153 PATIENTS Age range: 25 103 I Average age: 67 Unplanned discharge to acute hospital: 10% ALL STROKES STROKE REHABILITATION No two strokes are the same, so each patient s challenges are unique. Rehabilitation Hospital s CARF-accredited stroke rehabilitation program, the first in the region, is designed to meet the individual needs of patients age 14 and over who have suffered a recent embolic or hemorrhagic stroke. Patients admitted to the program must be medically stable and require intensive physician monitoring and an intensive interdisciplinary team approach to care. 14 72 % THE STROKE REHAB PROGRAM SCOPE OF SERVICES INCLUDES Providing comprehensive, individualized, interdisciplinary care regardless of race, cultural background, religion, gender, sexual orientation, age, ethnicity, language, physical or mental disabilities or social economic status. Providing education related to the recognition and prevention of stroke as well as the promotion of lifestyle changes to help reduce the risk of stroke reocurrence Maximizing independence for patients with physical, cognitive and psychosocial impairments LEFT STROKE right side affected Minimizing or removing barriers for participation in daily activities through rehabilitative techniques, compensatory strategies and adaptation Encouraging and enabling participation in community-level activities and life roles PROGRAM FEATURES 14 71 % RIGHT STROKE left side affected Rehabilitation physician Certified rehabilitation registered nurses* Interdisciplinary team approach* Dynavision Weekly team conferences Home evaluations* Community re-entry program* Dialysis support Driver rehabilitation *See Rehabilitation Terms (Page 6) Warm-water pool Assistive technology Outdoor mobility courtyard Body-weight supported gait trainer Transitional living apartment Diabetes education Spasticity management Coumadin education Advanced functional electrical stimulation Overhead track support system 13 71 % 7
MEDICAL REHABILITATION OUTCOMES BY DIAGNOSIS 224 PATIENTS Age range: 17 100 I Average age: 65 Unplanned discharge to acute hospital: 10% ORTHOPEDIC hip fractures, joint replacements, back surgeries, etc. 9 85 % Comprehensive Inpatient MEDICAL REHABILITATION The comprehensive inpatient medical rehabilitation program serves individuals who are at least 14 years of age who have complex medical, surgical or neurologic conditions. To qualify for admission, patients must be medically stable and require intensive physician monitoring and an intensive interdisciplinary team approach to care provided by physicians, nurses, therapists and case managers. Most patients receive a minimum of three hours of therapy at least five days per week and are seen at least three times a week by the rehabilitation physician. Nurses, many of whom are certified rehabilitation nurses, provide services 24/7. Common conditions treated include burns, cardiac issues, joint replacements, fractures, transplants, debility, traumas, multiple sclerosis and Parkinson s disease. THE INPATIENT REHABILITATION SCOPE OF SERVICES INCLUDES: DEBILITY Providing comprehensive, individualized, interdisciplinary care regardless of race, cultural background, religion, gender, sexual orientation, age, ethnicity, language, physical or mental disabilities or social economic status. Maximizing the independence of patients with physical, cognitive, and psychosocial impairments Minimizing or removing barriers to participation in daily activities through rehabilitative techniques, compensatory strategies and adaptation 12 76 % Educating patients and caregivers in rehabilitation techniques as well as planning strategies for the next level of care PROGRAM FEATURES Rehabilitation physician Interdisciplinary team approach* Orthotics and prosthetics Warm-water pool NEUROLOGIC multiple sclerosis, Parkinson s, polyneuropathy, etc. Weekly team conferences Certified rehabilitation registered nurses* Home evaluations* Community re-entry program* Dialysis support *See Rehabilitation Terms (Page 6) Assistive technology Outdoor mobility courtyard Body-weight supported gait trainer Transitional living apartment Ventricular assist device trained caregivers 11 82 % 8
BRAIN INJURY OUTCOMES 33 PATIENTS Age range: 16 89 I Average age: 59 Special Diagnosis BRAIN INJURY 12 67 % A brain injury can impact physical, cognitive and psychosocial function for years after an injury. That s why finding the best qualified rehabilitation program immediately after injury is so important. Rehabilitation Hospital has a team of certified brain injury specialists who treat patients age 14 and older who have suffered a recent traumatic or nontraumatic brain injury, such as a brain tumor, an anoxic or hypoxic event or infectious disease. Program participants must score a Rancho Los Amigos Scale* of at least four to be accepted. *See Rehabilitation Terms (Page 6) TRAUMATIC & NONTRAUMATIC SPINAL CORD INJURY OUTCOMES 30 PATIENTS Age range: 26 83 I Average age: 59 13 60 % Special Diagnosis SPINAL CORD INJURY A spinal cord injury, such as those caused by trauma and conditions such as tumors, can leave an individual with a variety of significant functional limitations. The rehab team focuses on maximizing remaining function in an effort to help patients reach the highest level of independence possible. Rehabilitation Hospital accepts patients with all levels of spinal cord injury, both complete and incomplete, who do not require mechanical ventilation and require an intensive interdisciplinary team approach to care. AMPUTATION OUTCOMES 18 PATIENTS Age range: 43 84 I Average age: 68 11 67 % Special Diagnosis AMPUTATION The loss of a limb can result in physical and emotional challenges. The goal at the Rehabilitation Hospital is to provide support as patients learn to manage those challenges and gain confidence. Treatment for upper- and lower-extremity amputations at all levels may include preprosthetic through prosthetic training. Rehabilitation Hospital accepts patients with amputations who have trauma or disease process that require an intensive interdisciplinary team approach to care. 97
42 DRIVER EVALUATIONS Specialized Outpatient Service DRIVER REHABILITATION PROGRAM Regaining independence often means relearning to drive. Rehabilitation Hospital s driver rehab program includes a comprehensive evaluation and recommendations on patients ability to resume driving. Therapists use a two-part evaluation process that begins with a clinical assessment of vision, cognition, strength and range of motion to determine driving potential. Based on results, clinicians may proceed to an on-the-road assessment, during which patients driving skills vehicle control, visual scanning, safety awareness, judgment and traffic safety are tested using a specially equipped training vehicle. PROGRAM FEATURES Specially trained occupational therapists Same-day recommendations provided to physician and patient Evaluations performed in specially equipped vehicle Additional driver s training services 10
D *Lutheran and Rehabilitation hospitals are owned in part by physicians. **Member of the medical staff of Lutheran Hospital.