Treat persons with brain injury by using sensory-motor reintegration and neurobehavioral rehabilitation in a supportive and home-like environment.

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1 Annual Report 2014

2 Introduction Thank you for your interest in learning more about Origami Brain Injury Rehabilitation Center. Origami opened in April 1997 through a creative alliance between Michigan State University and Peckham, Inc. Origami s vision is to create an enriched, natural environment in which persons with brain injury can achieve optimal participation in society. The intent of this Annual Report is to serve as a snapshot of our mission, who we serve, and the outcomes obtained in If you have further questions, you are encouraged to contact us through our website by sending an to or by calling (517) Our approach to the clients and families we serve, and our subsequent outcomes, are driven by our mission: Treat persons with brain injury by using sensory-motor reintegration and neurobehavioral rehabilitation in a supportive and home-like environment. Utilize community resources and real life responsibilities as the basis for therapeutic treatment. Operate a model program that generates excellent clinical outcomes with cost effective management. Educate family, friends, employers, and the community to facilitate the reintegration of persons with brain injury into society. Pursue scholarly development of innovative approaches to brain injury rehabilitation. All Programs Accredited By 2 Origami is the absolute best place to go when needing outstanding rehabilitation for brain injury. I am always amazed by the staff and results that my patients achieve. Origami is life changing and life affirming! - External Provider

3 Who We Served Over the past 17 years, Origami served over 800 individuals as well as supported their families and educated the community on issues surrounding brain injury. Origami consists of a unique multi- dimensional continuum Over the past 17 years, Origami served over 800 Who individuals We Served of care with 3 programs that include 2 tracks each, and 14 professional as well as supported services. In their 2014, Origami served a families and educated the community on issues surrounding brain injury. Origami consists record Over total the past of years, clients Origami across served the over continuum 800 individuals of care, as well an increase supported for their tenth families consecutive and educated year. of a unique multi-dimensional continuum of care with 3 programs that include 2 tracks each, the community on issues surrounding brain injury. Origami consists of a unique multi- dimensional continuum and 14 professional care with 3 services. programs that In 2014, include Origami 2 tracks each, served and 14 a professional record total services. of 187 In 2014, clients Origami across served the a continuum record of care, total an of 187 increase clients across for the tenth continuum consecutive of care, an increase year. for the tenth consecutive year. 200 Adolescents Served: N=7 (range years old) Who We Served Clients Served Annually Clients Served Annually Clients Served Annually Who We Served Over the past 17 years, Origami served over 800 individuals as well as supported their families and educated the 2001 community on issues 2004 surrounding brain 2007 injury Origami 2009 consists of a unique 2012 multi- dimensional continuum of care with 3 programs that include 2 tracks each, and 14 professional services. In 2014, Origami served a record total of 187 clients across the continuum of care, an increase for the tenth consecutive year. Admission Demographics Admission Demographics Admission Admissions by by Program Program 102 Total Admissions 102 Total Admissions Clients Served Annually Male: 52 (51%); Male: Female: 52 (51%); 50 (49%) Female: 50 (49%) ResidenXal Residential 200 n=13, n=13, 13% 13% 150 Single: (31%); Single: Total Married: 32 Admissions (31%); 50 (49%); Married: 50 (49%); Community Divorced: 15 (15%); Widowed: 5 (5%) 100 Community Based Divorced: 15 (15%); Widowed: 5 (5%) Based 50 n=1, n=1, 1% 1% Caucasian: 90 (88%); Hispanic: 3 (3%); 0 OutpaXent African- American: Caucasian: 8 (8%); Asian: 90 (88%); 0 (0%); Hispanic: 3 (3%); Outpatient n=88, 86% African- American: Other: 81 (8%); (1%) Asian: 0 (0%); n=88; 86% Other: 1 (1%) Age Total Percentage Admission Demographics Admissions: Injury Information Other: 4 1 (1%) 4% 102 Total Admissions 58 (58%) clients needed services as a result of a motor Age Total Percentage Male: 52 (51%); Female: 50 (49%) Admissions: % vehicle accident. Injury Information % 58 Admissions: (58%) clients needed Injury services Information as a result of a motor Single: 32 31% (31%); Married: 50 (49%); vehicle 58 (58%) accident. clients needed services as a result of Divorced: 37% 1518 (15%); Widowed: 18% 5 (5%) % 31 31% a motor vehicle accident Caucasian: 90 (88%); 4 Hispanic: 3 (3%); 4% African- American: 37 8 (8%); Asian: 37% 0 (0%); Adolescents Served: Other: 1 (1%) 12% 18% N=7 (range years old) Time from Date of Injury to Age Total 31 Percentage 31% Admissions: Injury Information Date of Origami Admission % 58 (58%) clients needed services as a result Services of a Adolescents motor Provided to Adolescents: Served: Cognitive Perceptual Motor Retraining, Occupational % 37% vehicle accident. N=7 (range years old) >5 years % Therapy, Physical Therapy, Psychology, Speech- 15% % 12% Language Pathology, Vision Therapy, Recreational <3 months Therapy, Services Neuro- Psychiatry, Provided and to Vocational Adolescents: % Services 33% 1-5 years Cognitive Perceptual Motor Retraining, Occupational Adolescents Served: 18% Therapy, Physical Therapy, Psychology, Speech- N=7 (range years old) Language Pathology, Vision Therapy, Recreational Therapy, Neuro- Psychiatry, Services Provided to Adolescents: and Vocational Services Cognitive Perceptual Motor Retraining, Occupational Therapy, Physical Therapy, Psychology, Speech- 3-6 months 6-12 months Language Pathology, Vision Therapy, Recreational 26% 8% Therapy, Neuro- Psychiatry, and Vocational Services Admission Demographics Male: 52 (51%); Female: 50 (49%) Single: 32 (31%); Married: 50 (49%) Divorced: 15 (15%); Widowed: 5 (5%) Caucasian: 90 (88%); Hispanic: 3 (3%) African-American: 8 (8%); Asian: 0 (0%) Age Total Percentage Services Provided to Adolescents: Cognitive Perceptual Motor Retraining, Occupational Therapy, Physical Therapy, Psychology, Speech-Language Pathology, Vision Therapy, Recreational Therapy, Neuro-Psychiatry, and Vocational Services We know that (our loved one) enjoys a comfortable and safe environment due to the residential staff s heart-felt concern and dedication. The job that they do, day in and day out, demands extraordinary patience and equanimity. - Family Member 3

4 Outcomes Amazing staff. Best rehab team ever!!! Will never refer elsewhere! Keep up the great work! Empowering and life affirming! Exceeded expectations! Case Manager Discharge Outcomes Client Goal Attainment (all programs): 78% (105 Discharge Outcomes goals set) Adolescents: 88% (17 goals set) Client Goal Attainment (all programs): 78% (105 goals set) Adolescents: 88% (17 goals set) Treatment Objectives Met (all programs): 86% (699 objectives set) Adolescents: 84% (88 objectives set) Outcomes Treatment Objectives Met (all programs): 86% (699 objectives set) Adolescents: 84% (88 objectives set) Overall Satisfaction (all programs) Overall Satisfaction (all programs) Clients: 4.6 out of 5.0 Clients: 4.6 out of 5.0 Family & External Stakeholders: 4.85 out of 5.0 Family & External Stakeholders: 4.85 out of 5.0 Predicted Length of Stay (all programs): 75% accuracy (n=57) Adolescents: 80% (n=6) Adolescents: 80% (n=6) Community Based & Outpatients Driving at Discharge: 65% (n=48) Those engaged in Vocational Services Those engaged in Vocational Services Reached productive activity: 92% (n=13) Attained productivity goal: 85% (n=13) Predicted Length of Stay (all programs): 75% accuracy (n=57) Community Based & Outpatients Driving at Discharge: 65% (n=48) Reached productive activity: 92% (n=13) Attained productivity goal: 85% (n=13) Average number of days from beginning service to initial productive activity: 35 days Family/Self 14% Case Manager 34% Referral Sources Other Referral Sources 2% Hospital 11% Health Care Provider 39% Average number of days from beginning service to initial Average Length of Service productive activity: 35 days Residential- Transitional (in days by track) Discharge Location Number Percent Outpagent (n=58) Discharge Community Follow-Up Living with Day (n=3) Intermittent Support 8 73% Community Integragon Completed 1279 Community at 1-month Living and with 6-month post (n=1) Semi- Independent 576 (n=2) discharge 24/7 (20 Supervision respondents, 34% response 2 18% rate) Residengal- Transigonal 61 (n=11) Those responding Licensed Group that Home their level has 1 remained 9% Residengal- Long Term No discharges in 2014 the same or Skilled improved Nursing Facility Average Length of Stay in the area of: 0 0% Place of residence/ (in days by track) Unplanned transfers to acute medical facilities: 5 independence 100% Outpatient Average (n=58) Number of Treatment Hours or Sessions Status of employment 95% Discharge Follow- Up Residential (hours per day) * 2.5 Quality of life 95% Day (n=3) Completed at 1- month and 6- month post discharge Semi- Independent Living (hours per day) ** 0.32 Driving (20 status 95% respondents, 34% response rate) Community Integration Community Integration (sessions per service) 1279 ** 5.9 (n=1) Those Social responding contact 100% that their level has remained the same Semi-Independent Outpatient 576 (sessions (n=2) per service) * 13 or improved in the area of: Place of residence/independence 100% Residential-Transitional 61 (n=11) *Clients completed program Responses of agree or strongly **Incorporates all clients in program throughout the year Status of employment 95% Residential-Long Term No discharges in 2014 agree that Origami Quality of life 95% prepared them for discharge: 100% Driving status 95% Social contact 100% Responses of agree or strongly agree that Origami prepared them for discharge: 100% Average Number of Treatment Hours/Sessions Residential (hours per day) * 2.5 Semi-Independent Living (hours per day) ** 0.32 Community Integration (sessions per service) ** 5.9 Outpatient/Day (sessions per service) * 13 *Clients completed program **Incorporates all clients in program throughout the year Residential-Transitional Discharge Location Community Living with Intermittent Support Community Living with 24/7 Supervision Number Percent 8 73% 2 18% Licensed Group Home 1 9% Skilled Nursing Facility 0 0% Unplanned transfers to acute medical facilities: 5 4

5 Community Outreach Origami takes pride in its active role in the community and hosted three primary community events in 2014, including the 14th annual Head s Up for Safety, 12th annual Origami 5K Run/Walk/Wheel, and 8th annual Brain Injury Symposium of Mid-Michigan. Head s Up for Safety partners Origami with community representatives in law and media to promote helmet safety and brain injury awareness by giving away bike helmets to local residents. The event in 2014 distributed 600 free helmets, increasing the total number of helmets given away since 2004 to 5,600. The 5K Race brings the community to the Origami campus in a health-conscious event to raise awareness of brain injury and money for the Origami Unfolding Potential Fund. Feedback was provided indicating enjoyment of the new race held at night. In addition, participants enjoyed the addition of the 400M Kids Dash. The Brain Injury Symposium of Mid-Michigan again featured a fantastic speaker line-up. The Symposium brings together professionals, family members, survivors and advocates, to learn about innovative and exciting trends in brain injury rehabilitation. Brain injury topics included concussions, spasticity, pain, yoga, and universal design. 93% of participants indicated satisfaction with the topics presented and their overall learning experience. There are no words in existence to do justice to the gratitude I have for all of Origami s efforts. Origami provides services that are so incredibly amazing. - Client 5

6 2014 Highlights The entire staff and team at Origami are very concerned with my well being and treatment. Thank you. - Client Treatment and Program Enhancement * Secured 3 grants for the addition of a cutting-edge driving simulator which further enhances Origami s pre-driving services * Cognitive Perceptual Motor Retraining (CPM) standardized evaluation battery of tests further enhanced through a re-norming study conducted with Grand Valley State University * Established relationship with Michigan State University s Department of Psychiatry, welcomed Dr. Jeffrey A. Frey to the Origami Team, and increased onsite psychiatry service hours * Established use of Goal Attainment Scaling (GAS) to objectively measure the success rate of achieving client stated goals * Established use of Quality of Life After Brain Injury (QOLIBRI) to objectively measure and consider client-perceived quality of life * Established Volunteer Chaplain for group and individual spiritual support Operational Initiatives and Developments * Completed State of Michigan Adult Foster Care Licensing inspection and achieved 2 year license with zero citations or notice of findings * Continued participation (1 of 21 facilities in the nation) in the Veterans Administration s Assisted Living TBI Pilot Program * Nurse Supervisor (Allie Burns) achieved a Certification as a Rehabilitation Registered Nurse (CRRN) * Speech-Language Pathologist (Danielle Pyle) achieved a Certification in the Practice of Cognitive Rehabilitation Therapy (CPCRT) * Occupational Therapist (Natasha Huffine) was invited by the Brain Injury Association of America to participate in a 3-year project dedicated to developing treatment guidelines for rehabilitation and chronic disease management of adults with moderate to severe traumatic brain injury * Physical Therapist (Ron Radawiec) was invited to participate in a concussion therapy pilot program * 100% of clinical team and many direct care employees earned or maintained certification as a Brain Injury Specialist (CBIS) * Origami employee has been accepted as a CARF International Medical Rehabilitation Surveyor (Natasha Huffine joins Tammy Hannah and Tom Judd) * Origami Board of Directors appointed a new Executive Director (Tammy Hannah) * Welcomed Kurt Schroeder to the position of Director of Operations * The position of Business Office Supervisor with certification as Billing and Coding Specialist (Jennifer Pascoe) was created allowing all medical billing to transition in-house * Clinical Manager (Amanda Carr) position was created Public Education * Thirty community presentations provided by Origami s employees (12 were geared for high school and college students) * 24 interns with average satisfaction of 3.9/4.0 * 42 job shadows * Provided grant funded brain injury education to the staff at a local skilled nursing facility * Hosted the 8th annual Brain Injury Symposium of Mid-Michigan with sold out attendance and 93% overall attendee satisfaction * Media engagements regarding brain injury awareness, sports concussions, return to driving, and annual events (5K race, Head s Up for Safety, and Symposium) * Active participation in advocacy efforts related to such areas as funding and prevention 6

7 Executive Leadership Tammy Hannah Executive Director, Origami Board of Directors Mitchell Tomlinson President President & Chief Executive Officer, Peckham, Inc. Mark Notman Vice President Associate Dean, Planning, Finance & Administration Chief Technical Officer Michigan State University College of Osteopathic Medicine Sue Waltersdorf Secretary and Treasurer Associate Controller, Michigan State University Scott Derthick Officer Vice President of Human Resources, Peckham, Inc. Dr. James Sylvain Officer Chairperson, Michigan State University PM&R Greta Wu Officer Senior Vice President of Human Services, Peckham, Inc. 7

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