Programs and Outcomes 2016 DATA

Programs and Outcomes 2016 DATA

Table of contents 3 At a Glance 4 Choosing Your Next Level of Care 5 Comprehensive Inpatient Medical Rehabilitation 6 Stroke Rehabilitation 7 Special Diagnosis: Brain Injury Special Diagnosis: Spinal Cord Injury Special Diagnosis: Amputation 8 Driver Rehabilitation Program 9 What to Expect at Rehabilitation Hospital 10 Patient Information 12 Frequently Asked Questions 14 Rehabilitation Terms 15 2016 Overall Patient Satisfaction ACCREDITATIONS The Rehabilitation Hospital of Fort Wayne is accredited by two organizations. The Joint Commission is responsible for evaluating and accrediting hospitals that voluntarily submit for inspection using specific standards for quality and safety. The Commission on Accreditation of Rehabilitation Facilities (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.

At a Glance The Rehabilitation Hospital of Fort Wayne is the region s only hospital dedicated solely to physical medicine and rehabilitation. Patients age 14 and older who have experienced a disabling injury or illness receive focused care from an interdisciplinary team whose goal is to help patients maximize their functional potential. A rehabilitation physician visits patients at least three times per week and other specialists follow patient progress based on individual needs. Physical, occupational and speech therapists provide intensive services in a structured environment that allows patients to set and meet goals, increase their thinking and communication skills, gain greater physical endurance and become more confident and independent. Registered nurses provide care and education 24/7. A clinical psychologist helps patients deal with emotional and cognitive disabilityrelated issues. Case managers coordinate team efforts and discharge planning. 646 PATIENTS IN 2016 11 Our team cares for patients in a free-standing, 36-bed comprehensive rehabilitation facility that includes: private and semi-private rooms a large therapy gym an activities-of-daily-living area a transitional living apartment an outdoor mobility courtyard a heated indoor therapy pool with lift-assist entry a private therapy room an overhead track and harness system to help patients walk or practice balance activities without fear of falling 73 UNPLANNED DISCHARGE TO ACUTE HOSPITAL 13 3

PROGRAMS Comprehensive inpatient medical rehabilitation program Stroke specialty program Driver rehabilitation program Choosing Your Next Level of Care Ready to be discharged, but not quite ready to go home? The Rehabilitation Hospital provides the level of care needed to help patients reach their goals. As the area s only hospital dedicated solely to physical medicine and rehabilitation, the benefits of our comprehensive inpatient program include: Medical Management Our full-time medical director manages each patient s rehabilitation A rehab physician meets with patients at least three times a week Other specialists follow patients progress as needed Intensity of Service Each patient receives therapy a minimum of three hours a day at least five days a week The 15 hours of weekly therapy can be spread out based on a patient s condition Registered nurses are available 24/7 Length of Stay The average length of stay for Rehabilitation Hospital patients is 11 days Upon discharge, 73 percent of patients return to their home versus an extended care facility Discharge Planning Case managers and nurses coordinate post-discharge care, including appointments, outpatient therapy sessions and home health care A staff member will call a few days after discharge to home and again two months after discharge for an update and to answer any questions Qualified Staff Rehabilitation physician Certified rehabilitation registered nurses Physical, occupational and speech therapists Certified brain injury specialists 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 Other SERVICES Assistive technology Case management/social work Clinical psychology Diabetes education Dialysis (hemo and peritoneal) Dietary Discharge planning Intravenous therapy Laboratory Nursing Nutritional counseling On-site rehabilitation physician Orthotics and prosthetics Pastoral care Pharmacy Physical, occupational and speech therapy Physician specialty consultations Radiology Respiratory therapy Wound care management Additional services available on a consulting basis. 4

Comprehensive Inpatient MEDICAL REHABILITATION The comprehensive inpatient medical rehabilitation program serves individuals who have complex medical, surgical or neurologic conditions. To qualify for admission, patients must be medically stable, require intensive physician monitoring and require an intensive interdisciplinary team approach to care provided by physicians, nurses, therapists and case managers. MEDICAL REHABILITATION PROGRAM OUTCOMES 331 PATIENTS Age range: 15 94 I Average age: 65 Unplanned discharge to acute hospital: 15 ORTHOPEDIC traumas, hip fractures, back surgeries, etc. Common conditions treated include burns, cardiac issues, orthopedic traumas, fractures, transplants, debility, traumas, multiple sclerosis and Parkinson s disease. THE INPATIENT REHABILITATION SCOPE OF SERVICES INCLUDES: 8 82 Providing comprehensive, individualized, interdisciplinary care Maximizing the independence of patients with physical, cognitive, and psychosocial impairments DEBILITY Minimizing or removing barriers to participation in daily activities through rehabilitative techniques, compensatory strategies and adaptation 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 10 73 Weekly team conferences Certified rehabilitation registered nurses* Home evaluations* Community re-entry program* Dialysis support and treatment Assistive technology Outdoor mobility courtyard Body-weight supported gait trainer Transitional living apartment Ventricular assist device trained caregivers NEUROLOGIC multiple sclerosis, Parkinson s, polyneuropathy, etc. * See Rehabilitation Terms (page 14) 11 67 5

STROKE REHABILITATION PROGRAM OUTCOMES 174 PATIENTS Age range: 25 103 I Average age: 67 Unplanned discharge to acute hospital: 11 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 who suffered a recent embolic or hemorrhagic stroke. Patients admitted to the program must be medically stable, require intensive physician monitoring and require an intensive interdisciplinary team approach to care. Stroke rehabilitation in an inpatient rehab facility (IRF) will provide the best outcomes, according to the American Heart Association/American Stroke Association. 13 64 LEFT STROKE right side affected THE STROKE REHABILITATION PROGRAM SCOPE OF SERVICES INCLUDES: Providing comprehensive, individualized, interdisciplinary care 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 recurrence Maximizing independence for patients with physical, cognitive and psychosocial impairments 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 13 67 RIGHT STROKE left side affected PROGRAM FEATURES Rehabilitation physician Certified rehabilitation registered nurses* Interdisciplinary team approach* Dynavision Weekly team conferences Home evaluations* Community re-entry program* Dialysis support and treatment Driver rehabilitation (outpatient) Warm-water pool Assistive technology Outdoor mobility courtyard Body-weight supported gait trainer Transitional living apartment Diabetes education Spasticity management Warfarin education Advanced functional electrical stimulation Overhead track support system * See Rehabilitation Terms (page 14) 14 63 6

Special Diagnosis: BRAIN INJURY BRAIN INJURY OUTCOMES 77 PATIENTS Age range: 14 93 I Average age: 52 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. 12 77 Special Diagnosis: SPINAL CORD INJURY TRAUMATIC & NONTRAUMATIC SPINAL CORD INJURY OUTCOMES 43 PATIENTS Age range: 17 83 I Average age: 54 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 rehabilitation 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. 14 74 Special Diagnosis: AMPUTATION AMPUTATION OUTCOMES 21 PATIENTS Age range: 43 84 I Average age: 65 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 from trauma or disease processes who require an intensive interdisciplinary team approach to care. 12 86 7

Specialized Outpatient Service: DRIVER REHABILITATION PROGRAM 43 DRIVER EVALUATIONS Regaining independence often means learning how to drive again. 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 8

What to Expect at Rehabilitation Hospital The first few days at the Rehabilitation Hospital are all about getting to know patients and their preferences and 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 the 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, if needed 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 5 6 p.m. 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. 9

Patient Information 10 Admission Documents Patients are asked to bring the following items at the time of admission: Insurance card, including Medicare and/or Medicaid cards Power of Attorney for the patient, if applicable Healthcare representative form, if applicable Living will or advance directive, if applicable These items will be copied and the originals returned. Patients unable to sign for themselves must be accompanied by a family member or responsible party. Clothing Patients at Rehabilitation Hospital wear their own clothing. Patients need comfortable shirts and slacks, shoes, undergarments and nightwear. A warm sweater or jacket is also recommended. Clothes should fit loosely so that exercise is unrestricted and be easy to put on and take off. The following is recommended: Five casual shirts/blouses Five pairs of loose-fitting slacks/shorts Four to five changes of undergarments, including socks or hosiery One to two pairs of shoes with good support and rubber soles Pajamas, robe and house slippers (hospital gowns are available) Grooming and toiletry items (toothbrush, toothpaste, razors, deodorant, cosmetics, shampoo and incontinence briefs) Seasonal outerwear Favorite pillow or blanket (marked with the patient s name) Personal reminders of home (pictures, photo albums, books, etc.) Corrective Devices Patients are asked to bring corrective devices and/or equipment, including glasses, hearing aids, prostheses, braces and other items to help them participate fully in rehabilitation programs. Discharge Planning Upon discharge, case managers and nursing staff help patients schedule follow-up physician appointments, outpatient therapy and/or home health services. Patients receive a phone call from a Rehabilitation Hospital team member a few days after discharge to home and again within two months after discharge to check on their status and answer any questions. Insurance Rehabilitation Hospital accepts funding from a variety of sources including Medicare, Medicaid, private insurance, HMO/PPO and self-payors. Case managers will help patients who are uninsured or unable to pay apply for the appropriate level of financial assistance. Patients are responsible for all deductibles and co-pays at the time of service unless other arrangements have been made.

Laundry The hospital does not provide laundry services and asks that patients arrange for a family member or friend to handle laundry needs every other day. Patients should have three to four changes of clothing available at the hospital at any given time. Meals The dietary staff provides a variety of fresh, home-cooked meals daily. Patients eat their meals in the dining room, unless there is a medical reason they need to stay in their room and/or bed. Family members and friends may eat with patients at a modest cost. Patients with dietary restrictions should check with the dietitian before eating or drinking any food or beverage that is not part of their regular meal. Medications Physicians need to know which drugs patients are currently taking, including prescription and over-the-counter medications, herbs and vitamins. Patients admitted to Rehabilitation Hospital from another facility will continue their medications as ordered by the transferring physician. Patients admitted from home should bring current medications to the hospital for their nurse to review. Home medications will be sent home with a family member after the review. Pharmacy will provide prescribed medications for patients while they are in the hospital. Nondiscrimination All patients receive comprehensive, individualized, interdisciplinary care regardless of their race, cultural background, religion, gender or sexual orientation. Patient Rooms Each spacious room has a large window, television, closet with plentiful drawer space, bedside telephone and a wheelchair-accessible bathroom with ample space for showering. Telephone To call a patient room directly from outside the hospital: Dial (260) 435-6116, 5 + room number + bed number. Outside callers must have the patient s room and bed number in hand. To avoid missed calls, patients should inform family and friends of their therapy and activity times. Valuables Valuables and/or cash should be sent home with a family member. If this is not possible, arrangements can be made to lock items in the safe in administration. Visitors Visiting hours are 8 a.m. 8 p.m. In order to ensure patients well-being, the care team has discretionary authority regarding the number of visitors and the length of time for each visit. Rehabilitation Hospital is located on the Lutheran Hospital campus, which is a tobacco-free campus. 11

Frequently Asked Questions How does an inpatient rehabilitation facility compare to other care options? The charts below illustrate five different types of care and the characteristics of each. LONG-TERM ACUTE CARE HOSPITAL (LTACH) INPATIENT REHABILITATION FACILITY (IRF) (Ex. The Rehabilitation Hospital of Fort Wayne) SKILLED NURSING FACILITY (SNF) TRANSITIONAL CARE UNIT (TCU) CONTINUING CARE UNIT (CCU) COMPLEXITY OF PATIENT ILLNESS HEALTH CARE OUTPATIENT REHABILITATION FACILITY CHARACTERISTICS LTACH IRF SNF/TCU/CCU Home Health Outpatient Able to manage complex medical conditions Average length of stay in days 25+ 11 25+ Varies Varies Rehab nursing Skilled nursing Minimum of 15 hours of therapy per week Able to provide physical, occupational and speech therapy Physician visits at least 3 times per week Interdisciplinary care provided Multidisciplinary care provided Case management services available Did you know? Stroke rehabilitation in an inpatient rehab facility (IRF) will provide the best outcomes, according to the American Heart Association /American Stroke Association. 12

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 schedule a tour, or stop by anytime. Will I be able to tolerate an intensive rehabilitation program? Our program is designed to provide a minimum of three 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 stay 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 home? 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. 13

Rehabilitation Terms CERTIFIED BRAIN INJURY SPECIALIST A clinician with advanced knowledge of brain injury evidenced by clinical experience, completion of a certification examination and annual education. CERTIFIED REHABILITATION REGISTERED NURSE (CRRN) A registered nurse with at least two years of experience in rehabilitation who has demonstrated advanced rehabilitation knowledge by passing a certification examination and 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 a patient home to assess the physical space and make recommendations that will allow the patient to safely return home. INTERDISCIPLINARY TEAM A team of healthcare professionals that coordinates efforts to reach a common patient goal. RANCHO LOS AMIGOS SCALE An evaluation scale that identifies patterns of recovery for people with a brain injury. 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: Rehab Metrics Report, Jan. 2016 Dec. 2016; 2016 Quarterly Data, HealthStream Data Research 14

2016 Overall Patient Satisfaction More than 97 of patients would recommend Rehabilitation Hospital of Fort Wayne.** All of the nurses and staff were great They worked with me to get better and they weren t easy on me, but seemed very concerned. I ve got to be honest everybody there was super. I d recommend the facility to anybody. I had a day where I was experiencing quite a bit of anxiety. Multiple staff members set aside time to spend time with me at my bedside Everybody was fabulous, always wanting to know if there was more they could do for me, if there was more care they could provide for me. Always being very sensitive and very compassionate to the trouble I was going through. This is the best stay in any medical facility that I have ever been in. They just excel at everything They were all just superb and I had a good rapport with some of the patients, which I really enjoyed. ** Based on Definitely yes and Probably yes responses to the question, Would you recommend Rehabilitation Hospital of Fort Wayne? from the 2016 quarterly HealthStream surveys. 15

Choosing Rehabilitation Hospital I How to refer Ask a social worker or case manager for a referral, or Ask a physician for a referral, or Call (260) 435-6121 and request an evaluation Rehabilitation Hospital Lutheran Medical Park 7970 W. Jefferson Blvd. Fort Wayne, IN 46804 Admissions: (260) 435-6121 Switchboard: (260) 435-6100 LutheranHealth.net/Rehab Rehabilitation Hospital is owned in part by physicians. Patient results may vary. Consult your physician. Rev. 05/2017