Scope of Care, Treatment and Services

Description

Rehabilitation at Sierra Campus for The Hospitals of Providence 24-bed private room Inpatient Rehabilitation Program offers comprehensive care to address the many needs of our patients and their medical conditions. Our team provides specialized care in a home-like setting environment to promote recovery from the most critical and complex medical and surgical conditions. Individual patient goals are set to maximize functionality and prepare our patients for an independent living return home and increased quality of life. Patients will benefit from specialized, intense Rehabilitation Program for medical needs that precluded them from being admitted into a lower level of care such as skilled nursing facility.

Scope of Services

Inpatient Rehabilitation Program at Sierra Campus provides a physician-led, comprehensive inpatient program for persons recovering from stroke, amputation, multiple trauma, head injury, spinal cord dysfunction, orthopedic conditions, neuromuscular disorders, oncology general debility, and other conditions requiring multidisciplinary rehabilitation. Patients must be adults from 18 years of age or older. Inpatient Rehabilitation Program is physically located on the fourth floor of THOP Sierra Campus. The Inpatient Rehabilitation Program is open 24 hours a day, seven days a week.

Patients will receive an intense level of therapy consisting of three hours of physical, occupation and/or speech therapy services five out of seven days a week. These programs will be aligned with the patient’s individualized plan of care. Based on patient needs other services, such as, respiratory, oncology, and cardiology, will be consulted. The program is sensitive to the cultural, gender, gender identity, ethnic, religious and personal needs of the persons served. The program gathers information on these needs from the individuals and their family members/significant others prior to and upon admission. Every effort is extended to meet these through program modification and, if required, additional services. Patients are encouraged to advise staff members of their personal preferences. THOP Sierra Campus does not allow discrimination or bias to occur and supports each individual’s cultural, ethnic, religious, sexual and gender needs and preferences.

Services and Hours

• Physician Services: 24 hours per day, 7 days per week
• Nursing Services: 24 hours per day, 7 days per week
• Respiratory Therapy: 24 hours, 7 days per week
• Pharmacy, laboratory and radiology services: 24 hours, 7 days per week
• Speech, Physical and Occupational Therapy are available Monday through Friday from 7:00 am to 5:00 pm and Saturdays from (minimum) 7:00 am to 3:00 pm
• Recreational Therapy is available Monday through Friday from 8:00 am to 4:00 pm
• Case management, social services, nutrition, psychologist, dialysis are hospital-based and available throughout the patient’s stay
• Patient access/insurance verification M-F 8:00 am to 4:30 pm
• Other services such as orthotics, prosthetics, audiology, driver re-education, vocational counseling and training, wheelchair and seating evaluations, chemical use/abuse/dependency counseling and psychiatry are available by referral to outside agencies

Intensity of Services

Patients are expected to participate in at least 3 hours of therapy per day, five out of seven days a week. If a patient is unable or unwilling to participate in therapy, the patient may be discharged to a more appropriate level of care.

Assessment/Reassessment

All patients require care by Registered Nurses. A Nursing admission assessment is to be completed within the shift of admission. Occupational, Physical, and Speech therapies complete initial evaluations within a 36 hour period of admission. Case Management/Social Work evaluation is conducted within 48 hours of admission. A team conference will be held within the first seven days post admission and weekly for each patient admitted to the inpatient rehabilitation unit.

Delivery of Care/Assignment

Daily shift needs are based on census. Variations are determined according to patient load and medical acuity using Optilink.

Management

The Program Director and Assistant Program Director have 24-hour responsibility to the unit, collaboratively. They are responsible for staffing, schedules, staff orientation, program development/education, evaluations and quality of patient care. The Assistant Program Director reports to the Program Director. The Program Director reports to the Chief Nursing Officer. Physical, Occupational and Speech Therapists report to the Director of Rehabilitation Services and the Therapy Supervisor. There is a dotted line from the Director of Rehabilitation and Therapy Supervisor to the Program Director for all program issues.

Support Systems

Inpatient Rehabilitation Program at Sierra Campus utilizes support services throughout the network and community and works closely with the Medical Staff Office, Nursing Department, Patient Safety Officer, Ancillary Departments, Medical Records, and Corporate Quality Management Department.

Referral Sources

Patients may be referred by physicians, discharge planners, allied health professionals, third party payers, patients or family members. Persons referred to the program will be screened according to admission criteria to determine their potential to participate in and benefit from a comprehensive inpatient rehabilitation program. The screening may be performed by the Admission Coordinator, Rehabilitation Physician or designee.

Payer Source

THOP Sierra Campus Inpatient Rehabilitation Program accepts patients from a variety of governmental (state and federal) insurance sources. Other funding’s are commercial insurance, selfinsured workplace health plans, workers compensation insurance and private pay sources. The hospital and its programs participate in the Medicare program.

Fees

Insurance coverage, benefits, and out of pocket liability fees are discussed with the patient/family prior to admission and throughout the patient’s stay if needed. THOP Sierra Campus is available to assist with benefits upon request.

Admission Criteria

1. Patient must be 18 years of age or older.
2. Complexity of Patient Needs
1. The patient must have significant functional deficits, as well as documented medical and nursing needs, regardless of diagnosis that require:
1. Close medical supervision by a physiatrist or a physician qualified by training and experience in rehabilitation.
2. 24 hour availability of nurses skilled in rehabilitation; and
3. Treatment by multiple other licensed rehabilitation professionals (such as physical therapists, occupational therapists, speech/language pathologist and prosthetic/orthotics).
2. The medical stability of the patient and management of medical or surgical co - morbidities are considered to be:
1. Manageable in the rehabilitation program.
2. Permit simultaneous participation in the rehabilitation program.
3. The patient presents as capable of fully participating in the inpatient rehabilitation program as evidenced by:
1. Mental status demonstrating responsiveness to verbal, visual and/or tactile stimuli and ability to follow simple commands.
2. An ability to actively participate in an intensive level of rehabilitation (generally defined as 3 hours of therapy per day, 5 out of 7 days a week).
4. The patient has objective and measurable functional goals identified to warrant the admission that:
1. Offer practical improvements and,
2. Are expected to be achieved within a reasonable amount of time.
5. The patient has reasonable probability of benefitting from the inpatient rehabilitation program.
6. The patient, in most circumstances, has a home and available family or care providers such that there is a likelihood of returning to home or a community based environment.
7. Spinal cord injured patients (including patients with traumatic injury and patients with spinal cord disease), complete and incomplete SC level C5 or below will be accepted but must also meet admission criteria listed above. Patients who are experiencing a late onset complication of spinal cord injury and require a period of hospitalization will also be considered. Such complications may include skin surgery, neurosurgery and other medical-surgical complications. Ventilator patients will not be accepted.

Continued Stay Criteria

Patient must demonstrate that they are benefitting from the program, that they are making progress toward reasonable goals and that acute rehab is the most appropriate level of care.

Discharge Criteria

The patient will be discharged from the Sierra Campus Inpatient Rehabilitation Program if any of the following are met:

1. Treatment goals necessitating the inpatient setting are met.
2. Absence of participation in the interdisciplinary rehabilitation program.
3. The individual has limited potential for recovery (e.g., the individual’s functional status has remained unchanged or additional functional improvement appears unlikely within a reasonable time frame).
4. The individual is unable to actively participate in an intensive rehabilitation program (most typically defined as at least 3 hours of therapy per day, 5 days per week).
5. The overall medical status is such that no further progress is anticipated or only minimal gains that could be expected to be attained with either less intensive therapy or regular daily activities.