Patient and Hospital Characteristics Associated with Assessment For Rehabilitation During Hospitalization for Acute Stroke

Size: px
Start display at page:

Download "Patient and Hospital Characteristics Associated with Assessment For Rehabilitation During Hospitalization for Acute Stroke"

Transcription

1 Patient and Hospital Characteristics Associated with Assessment For Rehabilitation During Hospitalization for Acute Stroke Lead Author: Janet Prvu Bettger, ScD, FAHA Duke University ; ISC 2012, Wednesday, February 1, 2012, 8:42-8:54 a.m., Room Multidisciplinary Rehab Session, Oral Presentation #21

2 Disclosure Information Author Disclosure Information J. Prvu Bettger: Research Grant - AHRQ L. Kaltenbach, M. Reeves, E.E. Smith, G.C. Fonarow, E.D. Peterson: None L.H. Schwamm: Other; Modest (Chair, AHA GWTG, unpaid) The GWTG-Stroke program is provided by the AHA/ASA. The GWTG-Stroke program DISCLOSURE is currently supported INFORMATION: in part by a charitable contribution from Bristol- Myers Squib/Sanofi Pharmaceutical Partnership and the AHA Pharmaceutical Roundtable. GWTG-Stroke has been funded in the past through support from Boeringher-Ingelheim and Merck.

3 Patient and Hospital Characteristics Associated with Assessment For Rehabilitation During Hospitalization for Acute Stroke? Janet Prvu Bettger, Duke Univ; Lisa Kaltenbach, Duke Clinical Res Inst; Mathew Reeves, Michigan State Univ; Eric E Smith, Univ of Calgary; Gregg C Fonarow, UCLA; Lee H Schwamm, Massachusetts General Hosp; Eric D Peterson, Duke Clinical Res Inst.

4 We know Stroke is a leading cause of serious, long-term disability among adults in the U.S. 3 of 4 stroke survivors are dependent at some level for self-care 15-30% of adult stroke patients report severe disability post-stroke Rogers et al., Circulation 2011

5 We also know: Rehabilitation initiated early following stroke can enhance the recovery process and minimize functional disability Better clinical outcomes when stroke patients receive coordinated, multidisciplinary evaluation and intervention in organized and coordinated inpatient rehabilitation (Evans et al., Lancet 2001; Langhorne & Duncan, Stroke 2001; Prvu Bettger & Stineman, Archives PMR 2007; Teasell et al., Top Stroke Rehabil. 2003

6 Should we be looking at the delivery of rehab in acute care?

7 all acute ischemic and hemorrhagic stroke patients be assessed for rehabilitation services as early as medically and neurologically possible to ensure optimal outcomes AHCPR 1995; Duncan et al., Stroke 2005; Schwamm et al., Stroke 2005

8 Purpose of the study: To examine the degree and determinants of an acute assessment for rehabilitation following acute stroke

9 Overview Prospective cohort of patients with data documented as part of the GWTG-Stroke program initiated and supported by AHA ongoing, voluntary, continuous registry and QI initiative for acute hospitals Outcome Sciences, Inc. = data collection and coordination center DCRI = data analysis center

10 Documentation of Rehab in Acute Care

11 Defined As

12 Study Population Patients admitted to a GWTG-Stroke participating hospital 01/01/08-03/31/11 962,856 stroke admissions from 1540 participating hospitals Excluded: patients with TIA (N=206,217) no stroke related dx (N=18,180) died in-hospital (N=65,680) left AMA, missing d/c code or date (N=13,005) transfers (N=65,280)

13 616,982 eligible stroke admissions from 1523 GWTG-Stroke participating hospitals Median age = 72 years (IQR 60-82) 52% female 70% White 3.5% unable to ambulate prior to stroke Sample

14 Are Stroke Patients Being Assessed For Rehabilitation In The Acute Hospital? Assessed for Rehabilitation N=552,222 Not Assessed for Rehabilitation N=64, % 10.5%

15 Multivariate Model (Strongest Predictors) Characteristics Independently Associated With the Receipt of An Assessment for Rehabilitation Variable OR 95% CI P-value Patient Characteristics Age (per 10-year increase) <.0001 In rehab setting or LTC prior <.0001 Medical History Unable to ambulatory prior to <.0001 admission (ref. = independent) Atrial Fibrillation or Flutter <.0001 Diabetes Mellitus <.0001 Hospital Characteristics Received Care in a Stroke Unit <.0001 C =0.6843

16 Looking a little closer

17 Patient Sociodemographics Variable, Level Assessed for Rehabilitation Not Assessed for Rehabilitation Socio-demographics N=552,223 N=64,760 Age in years, Mean (STD) 69.5 (14.7) 75.5 (15.3) Gender, Female 51.3% 59.0% Race and Ethnicity White 69.2% 76.9% Black or African American 17.0% 10.5% Other Race 13.8% 12.6% Health Insurance* Self Pay/No Insurance 6.6% 3.8% Medicare 40.9% 47.2% Medicaid 8.7% 7.8% Private/VA/Other 43.9% 41.1% Admitted from post-acute or LTC 5.7% 18.5%

18 Preadmission Clinical History Medical History (Obtained On Admission) Assessed for Rehabilitation N=552,222 Not Assessed for Rehabilitation N=64,760 Pre-stroke ambulatory status* Unable to ambulate 2.8% 9.5% Ambulating with person assist 4.7% 8.8% Ambulating independently 80.1% 62.1% Previous Stroke/TIA 32.1% 35.7% Atrial Fibrillation or Flutter 16.6% 26.3% CAD or Prior MI 26.4% 29.6% Diabetes Mellitus 33.3% 28.5% Dyslipidemia 43.0% 38.7% Heart Failure 7.7% 12.0% Hypertension 81.3% 79.6% Peripheral Vascular Disease 4.7% 5.8% Smoker 20.6% 13.0%

19 Status on Admission Stroke Symptoms resolved on admission* Assessed for Rehabilitation N=552,222 Not Assessed for Rehabilitation N=64,760 Ambulatory status at admission* Unable to ambulate 18.6% 33.2% Ambulating with person assist 16.3% 7.0% Ambulating independently 24.0% 16.6% Stroke symptoms resolved* 5.4% 5.0% 1st NIHSS total score, Mean (STD)* 6.5 (6.8) 13.9 (10.5) *Missing data

20 Variable, Level Hospital Characteristics Assessed for Rehabilitation N=552,222 Not Assessed for Rehabilitation N=64,760 Care Delivery % % NIHSS Total Score Documented Patient had a Stroke Consult* Received Care in a Stroke Unit* Received Thrombolytic Therapy Comfort care measures only Length of Stay, Mean # of days (STD) 6.2 (7.34) 5.6 (6.9) Structural Characteristics % % Hospital Beds, Mean # (STD)* (337.1) (336.3) Geographic Region of the Country West South Midwest Northeast Hospital Type, Academic* Urban Designation by RUCA Codes

21 Discharge Disposition Referred for Rehabilitation at Discharge Assessed for Rehabilitation N=552,222 Not Assessed for Rehabilitation N=64,760 No rehabilitation (discharge home no services) Discharged to Post-acute care: (inpatient rehabilitation unit or facility) (26.0) (2.3) (skilled nursing facility or (20.4) (13.7) Medicare equivalent subacute unit [swing bed]) (0.3) (0.2) (home with home health) (11.5) (2.8) (long term acute hospital) (1.2) (1.0) No rehabilitation: discharge to hospice discharge to long-term care

22 CONCLUSIONS Nearly all patients had documentation of an assessment for rehabilitation or that rehabilitation services were provided Care in a stroke unit increased the likelihood of an assessment Older age and hx of afib. decreased the likelihood Patients admitted from LTC or post-acute care or who were unable to ambulate prior their stroke admission were half as likely to be assessed

23 PRACTICE IMPLICATIONS What does assessed for rehabilitation mean? Patients who have had an ischemic or hemorrhagic stroke with resultant impairments and limitations in activities, as identified on the brief assessment, should be referred to rehabilitation services for an assessment of rehabilitation needs. 1. Assess function 2. Refer to rehab Duncan, Stroke Rehab Clinical Practice Guidelines, 2005

24 Measurement of Practice Improve clarity in coding instructions for acute hospitals documenting rehab assessment E.g., transfer or referral to rehab assessment of rehab need was completed Standardize the assessment process (physician or nursing assessment of function refer for assessment by rehab team stroke team makes an informed decision about acute care goals/needs and appropriate post-acute services) Determine optimal methods for supporting acute hospitals toward evidence-based care

25 POLICY IMPLICATIONS Several U.S. stroke initiatives require documentation of a rehabilitation assessment Paul Coverdell National Acute Stroke Registry (2004) The Joint Commission for acute hospital stroke center certification (2006) Endorsed by the National Quality Forum (2008) AHA GWTG-Stroke hospital-based data registry and quality improvement program (2008) Inclusion/exclusion for each differs slightly and differs from clinical recommendations In this study: 89.5% could easily have been 96% (e.g., inclusion of d/c to rehab, exclude d/c to hospice)

26 POLICY IMPLICATIONS (continued) Opportunity exists for all acute stroke quality initiatives to achieve consensus on defining an evidence-based quality measure that will best support patient-centered outcomes and appropriate use of rehabilitation services both in the hospital and after discharge. More stringent and specific measures needed Function assessed (mobility, self-care, communication & cognition) Referred to rehab team Time to receipt of rehabilitation Future measure to evaluate quality of rehab in acute care

27 FUTURE RESEARCH Identify indicators of referral to rehab team Determine what is an assessment for rehab Differentiate who receives rehab in acute care only, post-acute only, or both Examine how decisions made in acute care impact patient and health system outcomes

28 ACKNOWLEDGEMENTS Special thanks to AHA for supporting the analyses Thanks to the statistical team and mentorship at DCRI Support Dr. Prvu Bettger from the AHRQ Comparative Effectiveness Research Mentored Scholar Program (K12HS019479, PI: Oddone).

Organization of Rehabilitation and Post-Acute Care

Organization of Rehabilitation and Post-Acute Care Organization of Rehabilitation and Post-Acute Care Inaugural Meeting of NECC Boston, MA - September 13, 2006 Janet Prvu Bettger, ScD University of Pennsylvania Department of Physical Medicine and Rehabilitation

More information

Get With The Guidelines - Stroke PMT Special Initiatives Tab for Ohio Coverdell Stroke Program CODING INSTRUCTIONS Effective 10-24-15

Get With The Guidelines - Stroke PMT Special Initiatives Tab for Ohio Coverdell Stroke Program CODING INSTRUCTIONS Effective 10-24-15 Get With The Guidelines - Stroke PMT Special Initiatives Tab for Ohio Coverdell Stroke Program CODING INSTRUCTIONS Effective 10-24-15 Date and time first seen by ED MD: The time entered should be the earliest

More information

Rehabilitation Pilot Project

Rehabilitation Pilot Project Rehabilitation Pilot Project Chair: Joel Stein, MD, Columbia University Medical Center Vice-Chair: Alyse Sicklick, MD, Gaylord Hospital Additional Project Leads: Janet Prvu Bettger, ScD, Duke University

More information

Stroke Rehabilitation Triage Severe Strokes

Stroke Rehabilitation Triage Severe Strokes The London Stroke Rehab Data Base Project Robert Teasell MD FRCPC Professor and Chair-Chief Department of Phys Med Rehab London Ontario Retrospective Data Bases In stroke rehab limited funding for clinical

More information

Best Practice Recommendations for Inpatient Stroke Care: Rationale and Evidence for Integrated Stroke Units in North Simcoe Muskoka LHIN

Best Practice Recommendations for Inpatient Stroke Care: Rationale and Evidence for Integrated Stroke Units in North Simcoe Muskoka LHIN Best Practice Recommendations for Inpatient Stroke Care: Rationale and Evidence for Integrated Stroke Units in North Simcoe Muskoka LHIN Physician Education Session May 24, 2013 Dr. Mark Bayley,, Cheryl

More information

ALBERTA PROVINCIAL STROKE STRATEGY (APSS)

ALBERTA PROVINCIAL STROKE STRATEGY (APSS) ALBERTA PROVINCIAL STROKE STRATEGY (APSS) Stroke Systems of Care Key Components APSS Pillar Recommendations March 28, 2007 1 The following is a summary of the key components and APSS Pillar recommendations

More information

Selection of Post-Acute Rehabilitation Facilities in the Northeast: A Survey of Discharge Planners

Selection of Post-Acute Rehabilitation Facilities in the Northeast: A Survey of Discharge Planners Selection of Post-Acute Rehabilitation Facilities in the Northeast: A Survey of Discharge Planners Alyse Sicklick, MD, Joel Stein, MD, Robin Hedeman, OTR, MHA, Janet Prvu Bettger, ScD, Zainab Magdon-Ismail,

More information

Chapter 3: Review of Literature Stroke

Chapter 3: Review of Literature Stroke Chapter 3: Review of Literature Stroke INTRODUCTION Cerebrovascular accident (also known as stroke) is a serious health problem in the United States and a leading cause of long-term disability. In this

More information

Hospital-Based Sub-Acute Stroke Care and Secondary Prevention. Timothy Lukovits,, M.D.

Hospital-Based Sub-Acute Stroke Care and Secondary Prevention. Timothy Lukovits,, M.D. Hospital-Based Sub-Acute Stroke Care and Secondary Prevention Timothy Lukovits,, M.D. Volunteer group members Shalini Bansil,, MD Summit NJ Ji Chong,, MD, NYC, NY Srinath Kadimi,, M.D. Fairfield, CT Steve

More information

Texas Heart Attack and Stroke Data Collection Initiative: Data Update. Nimisha Bhakta, MPH Texas Heart Attack and Stroke Summit July 24, 2015

Texas Heart Attack and Stroke Data Collection Initiative: Data Update. Nimisha Bhakta, MPH Texas Heart Attack and Stroke Summit July 24, 2015 Texas Heart Attack and Stroke Data Collection Initiative: Data Update Nimisha Bhakta, MPH Texas Heart Attack and Stroke Summit July 24, 2015 Presenter Disclosure Information FINANCIAL DISCLOSURE: I have

More information

Department of Veterans Affairs VHA DIRECTIVE 2011-038 Veterans Health Administration Washington, DC 20420 November 2, 2011

Department of Veterans Affairs VHA DIRECTIVE 2011-038 Veterans Health Administration Washington, DC 20420 November 2, 2011 Department of Veterans Affairs VHA DIRECTIVE 2011-038 Veterans Health Administration Washington, DC 20420 TREATMENT OF ACUTE ISCHEMIC STROKE (AIS) 1. PURPOSE: This Veterans Health Administration (VHA)

More information

Background. Does the Organization of Post- Acute Stroke Care Really Matter? Changes in Provider Supply. Sites for Post-Acute Care.

Background. Does the Organization of Post- Acute Stroke Care Really Matter? Changes in Provider Supply. Sites for Post-Acute Care. Does the Organization of Post- Acute Stroke Care Really Matter? Pamela W. Duncan, PhD, FAPTA University of Florida Brooks Center for Rehabilitation Studies Department of Veteran Affairs Rehabilitation

More information

Successful Early Career Research Using Get With The Guidelines

Successful Early Career Research Using Get With The Guidelines Early Career: Starting a Successful Career in Quality of Care and Outcomes Research Successful Early Career Research Using Get With The Guidelines Gregg C. Fonarow, MD Eliot Corday Professor of Cardiovascular

More information

Comparison of Discharge Functional Status Rehabilitation: Hip Fracture Repair. Trudy Mallinson, PhD, OTR/L

Comparison of Discharge Functional Status Rehabilitation: Hip Fracture Repair. Trudy Mallinson, PhD, OTR/L Comparison of Discharge Functional Status Rehabilitation: Hip Fracture Repair Trudy Mallinson, PhD, OTR/L Acknowledgements Co-authors Anne Deutsch, PhD, CRRN Jillian Bateman, OTD, OTR/L Hsiang-Yi Tseng,

More information

Janet Prvu Bettger 1*, Xin Zhao 2, Cheryl Bushnell 3, Louise Zimmer 2, Wenqin Pan 2, Linda S Williams 4 and Eric D Peterson 2

Janet Prvu Bettger 1*, Xin Zhao 2, Cheryl Bushnell 3, Louise Zimmer 2, Wenqin Pan 2, Linda S Williams 4 and Eric D Peterson 2 Bettger et al. BMC Public Health 2014, 14:281 RESEARCH ARTICLE Open Access The association between socioeconomic status and disability after stroke: Findings from the Adherence evaluation After Ischemic

More information

TORONTO STROKE FLOW INITIATIVE - Inpatient Rehabilitation Best Practice Recommendations Guide (updated January 23, 2014)

TORONTO STROKE FLOW INITIATIVE - Inpatient Rehabilitation Best Practice Recommendations Guide (updated January 23, 2014) TORONTO STROKE FLOW INITIATIVE - Inpatient Rehabilitation Best Practice Guide (updated January 23, 2014) Objective: To enhance system-wide performance and outcomes for persons with stroke in Toronto. Goals:

More information

American Stroke Association Highlights Carla D. English, MHS, MHSA

American Stroke Association Highlights Carla D. English, MHS, MHSA AMERICAN STROKE ASSOCIATION HIGHLIGHTS 1 CARLA D. ENGLISH, MHS, MHSA QUALITY & SYSTEMS IMPROVEMENT GREATER SOUTHEAST AFFILIATE ASA VISION: Empower people to live longer, healthier lives free of stroke

More information

TORONTO STROKE FLOW INITIATIVE - Outpatient Rehabilitation Best Practice Recommendations Guide (updated July 26, 2013)

TORONTO STROKE FLOW INITIATIVE - Outpatient Rehabilitation Best Practice Recommendations Guide (updated July 26, 2013) Objective: To enhance system-wide performance and outcomes for persons with stroke in Toronto. Goals: Timely access to geographically located acute stroke unit care with a dedicated interprofessional team

More information

The International Agenda for Stroke

The International Agenda for Stroke 1st Global Conference on Healthy Lifestyles and Noncommunicable Diseases Control Moscow, 28-29 April, 2011 The International Agenda for Stroke Marc Fisher MD, University of Massachusetts Editor-in-Chief,

More information

Stroke Transitions of Care. Hospital Environment to Home

Stroke Transitions of Care. Hospital Environment to Home Stroke Transitions of Care Hospital Environment to Home Disclosures NONE Objectives Understand the importance of effective transitional care from the acute hospital to home in the stroke population Discuss

More information

AHA/ASA Ischemic Stroke Performance Measures

AHA/ASA Ischemic Stroke Performance Measures AHA/ASA Ischemic Stroke Performance Measures 1. Venous thromboembolism prophylaxis Percentage of patients with ischemic stroke who receive venous thromboembolism prophylaxis Numerator Hospital day 0 or

More information

AlphaFIM Instrument Too ol1 Mild Stroke Project (Part II) Report

AlphaFIM Instrument Too ol1 Mild Stroke Project (Part II) Report 1 AlphaFIM Instrument Tool 1 Mild Stroke Project (Part II) Report Prepared by: Carmel Forrestal Regional Stroke Rehab Coordinator 1 The FIM instrument and AlphaFIM instrument referenced herein are the

More information

DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services. Discharge Planning

DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services. Discharge Planning DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services ICN 908184 October 2014 This booklet was current at the time it was published or uploaded onto the web. Medicare policy

More information

Stakeholder s Report. 2525 SW 75 th Ave Miami, Florida 33155 305.262.6800 www.westgablesrehabhospital.com

Stakeholder s Report. 2525 SW 75 th Ave Miami, Florida 33155 305.262.6800 www.westgablesrehabhospital.com 212 Stakeholder s Report 2525 SW 75 th Ave Miami, Florida 33155 35.262.68 www.westgablesrehabhospital.com PROFILE REPORT For more than 25 years, West Gables Rehabilitation Hospital has made a mission of

More information

Homeward Bound. Amanda Melvin, MSW Emily Hartman, BSN, RN Tiffany Curtis, BSN, RN, CRRN Cindy Regan, MSN, RN - BC

Homeward Bound. Amanda Melvin, MSW Emily Hartman, BSN, RN Tiffany Curtis, BSN, RN, CRRN Cindy Regan, MSN, RN - BC Homeward Bound Amanda Melvin, MSW Emily Hartman, BSN, RN Tiffany Curtis, BSN, RN, CRRN Cindy Regan, MSN, RN - BC Objectives Identify and differentiate the levels of stroke rehabilitation care. Identify

More information

The American Heart Association s (AHA) stated mission

The American Heart Association s (AHA) stated mission AHA/ASA Presidential Advisory Translating Evidence Into Practice: A Decade of Efforts by the American Heart Association/American Stroke Association to Reduce Death and Disability Due to Stroke A Presidential

More information

SENATE, No. 368 STATE OF NEW JERSEY. Introduced Pending Technical Review by Legislative Counsel PRE-FILED FOR INTRODUCTION IN THE 1996 SESSION

SENATE, No. 368 STATE OF NEW JERSEY. Introduced Pending Technical Review by Legislative Counsel PRE-FILED FOR INTRODUCTION IN THE 1996 SESSION SENATE, No. STATE OF NEW JERSEY Introduced Pending Technical Review by Legislative Counsel PRE-FILED FOR INTRODUCTION IN THE SESSION By Senators MATHEUSSEN and LYNCH 0 0 AN ACT concerning subacute care

More information

Stroke: Major Public Health Burden. Stroke: Major Public Health Burden. Stroke: Major Public Health Burden 5/21/2012

Stroke: Major Public Health Burden. Stroke: Major Public Health Burden. Stroke: Major Public Health Burden 5/21/2012 Faculty Prevention Sharon Ewer, RN, BSN, CNRN Stroke Program Coordinator Baptist Health Montgomery, Alabama Satellite Conference and Live Webcast Monday, May 21, 2012 2:00 4:00 p.m. Central Time Produced

More information

SECTION B THE SERVICES COMMUNITY STROKE REHABILITATION SPECIFICATION 20XX/YY

SECTION B THE SERVICES COMMUNITY STROKE REHABILITATION SPECIFICATION 20XX/YY SECTION B THE SERVICES COMMUNITY STROKE REHABILITATION SPECIFICATION 20XX/YY SECTION B PART 1 - SERVICE SPECIFICATIONS Service specification number Service Commissioner Lead Provider Lead Period Date of

More information

Cardiovascular Health & Stroke SCN Project Overview

Cardiovascular Health & Stroke SCN Project Overview Cardiovascular Health & Stroke SCN Project Overview Background The Alberta Provincial Stroke Strategy (APSS) has been successful in enhancing rural and urban stroke care across the province with improved

More information

Accreditation and Certification Guidelines

Accreditation and Certification Guidelines Accreditation and Certification Guidelines MARTIN GIZZI, MD, PHD, FAHA CHAIR, NJ NEUROSCIENCE INSTITUTE AT JFK CHAIR, NORTH EAST CEREBROVASCULAR CONSORTIUM (NECC) CHAIR, STROKE ADVISORY PANEL, NJDOH MEMBER,

More information

May 7, 2012. Submitted electronically via www.regulations.gov. Re: CMS 0044 P. Dear Administrator Tavenner:

May 7, 2012. Submitted electronically via www.regulations.gov. Re: CMS 0044 P. Dear Administrator Tavenner: Marilyn Tavenner Administrator Centers for Medicare and Medicaid Services (CMS) Department of Health and Human Services P.O. Box 8013 Baltimore MD 21244 8013 Submitted electronically via www.regulations.gov

More information

FL PR Stroke Registry Goals

FL PR Stroke Registry Goals 20 th Annual Stroke Belt Consortium Meeting FL PR Goals To evaluate for disparities in stroke performance metrics by Race and ethnicity Geographic regions in Florida and Puerto Rico To investigate t the

More information

PARTNERSHIP HEALTHPLAN OF CALIFORNIA POLICY / PROCEDURE:

PARTNERSHIP HEALTHPLAN OF CALIFORNIA POLICY / PROCEDURE: PARTNERSHIP HEALTHPLAN OF CALIFORNIA POLICY/PROCEDURE Policy Number: MCUP3003 (previously UP100303) Reviewing Entities: Credentialing IQI P & T QUAC Approving Entities: BOARD CEO COMPLIANCE FINANCE PAC

More information

2016 International Stroke Conference Hot Topics Lori M. Massaro, MSN, CRNP Kari Moore, MSN, AGACNP-BC

2016 International Stroke Conference Hot Topics Lori M. Massaro, MSN, CRNP Kari Moore, MSN, AGACNP-BC 2016 International Stroke Conference Hot Topics Lori M. Massaro, MSN, CRNP Kari Moore, MSN, AGACNP-BC Disclosures Lori M. Massaro, MSN,CRNP speakers bureau Genentech Kari Moore, MSN, AGACNP-BC -none 1

More information

Stroke/VTE Quality Measure Build for Meaningful Use Stage 1

Stroke/VTE Quality Measure Build for Meaningful Use Stage 1 Stroke/VTE Quality Measure Build for Meaningful Use Stage 1 Presented by Susan Haviland, BSN RN Senior Consult, Santa Rosa Consulting Meaningful Use Quality Measures Centers for Medicare and Medicaid Services

More information

Presenter Disclosure Information

Presenter Disclosure Information Presenter Disclosure Information Mathew J. Reeves PhD, FAHA From Research to Reality: How YOUR Data Collection Efforts Impact Bedside Care and Improvements in Quality FINANCIAL DISCLOSURE: None UNLABELED/UNAPPROVED

More information

Performance Measurement for the Medicare and Medicaid Eligible (MME) Population in Connecticut Survey Analysis

Performance Measurement for the Medicare and Medicaid Eligible (MME) Population in Connecticut Survey Analysis Performance Measurement for the Medicare and Medicaid Eligible (MME) Population in Connecticut Survey Analysis Methodology: 8 respondents The measures are incorporated into one of four sections: Highly

More information

Inpatient Rehabilitation Facilities (IRFs) [Preauthorization Required]

Inpatient Rehabilitation Facilities (IRFs) [Preauthorization Required] Inpatient Rehabilitation Facilities (IRFs) [Preauthorization Required] Medical Policy: MP-ME-05-09 Original Effective Date: February 18, 2009 Reviewed: April 22, 2011 Revised: This policy applies to products

More information

Clinical Characterization of Patients with Acute First-Ever Ischemic Stroke and Atrial Fibrillation by Using the CHADS 2

Clinical Characterization of Patients with Acute First-Ever Ischemic Stroke and Atrial Fibrillation by Using the CHADS 2 Clinical Characterization of Patients with Acute First-Ever Ischemic Stroke and Atrial Fibrillation by Using the CHADS 2 Score: Results From the German Ludwigshafen Stroke Study (LuSSt) Kleemann T¹, Urbanek

More information

Stroke Rehab Across the Continuum of Care in Quinte Region

Stroke Rehab Across the Continuum of Care in Quinte Region Stroke Rehab Across the Continuum of Care in Quinte Region Adrienne Bell Smith Manager of Rehab Therapies QHC Karen Brown Manger Client Services, Hospital Access South East CCAC Disclosure of Potential

More information

INTRO TO THE MICHIGAN PIONEER ACO 101: THE BASICS. Karen Unholz, RN, BSN

INTRO TO THE MICHIGAN PIONEER ACO 101: THE BASICS. Karen Unholz, RN, BSN INTRO TO THE MICHIGAN PIONEER ACO 101: THE BASICS Karen Unholz, RN, BSN Origins of the Accountable Care Organization ACOs originated from the Patient Protection and Affordable Care Act (Healthcare Reform)

More information

Developing a Dynamic Team Approach to Stroke Care. Emergency Medical Services 2015

Developing a Dynamic Team Approach to Stroke Care. Emergency Medical Services 2015 Developing a Dynamic Team Approach to Stroke Care Emergency Medical Services 2015 Why Stroke, Why now? A recent study showed that 80 percent of people in the United States live within an hour s drive of

More information

Improving access to psychological therapies for people with severe and enduring mental health problems: rehabilitation psychiatrists perspectives

Improving access to psychological therapies for people with severe and enduring mental health problems: rehabilitation psychiatrists perspectives Improving access to psychological therapies for people with severe and enduring mental health problems: rehabilitation psychiatrists perspectives Dr Helen Killaspy Reader and honorary consultant in rehabilitation

More information

Performance Measures for. What? When? How?

Performance Measures for. What? When? How? Performance Measures for Cardiac and Pulmonary Rehabilitation: What? When? How? 5th Cardiopulmonary Rehabilitation Workshop 2011- Webinar Seoul, Korea Friday, April 29, 2011 Randal J. Thomas, MD, MS, FAACVPR,

More information

BRIEFING PAPER STROKE SERVICES REDESIGN

BRIEFING PAPER STROKE SERVICES REDESIGN 1. Introduction BRIEFING PAPER STROKE SERVICES REDESIGN Agenda Item 3 Stroke is the leading cause of adult disability in Wales, and the third most common cause of death, after cancer and heart disease.

More information

How many RCTs in Stroke Rehab?

How many RCTs in Stroke Rehab? Evidence Based Stroke Rehabilitation: Maximizing Recovery and Improving Outcomes Robert Teasell MD FRCPC Professor and Chair Chief Physical Medicine & Rehabilitation St. Joseph s Health Care London University

More information

Good Samaritan Inpatient Rehabilitation Program

Good Samaritan Inpatient Rehabilitation Program Good Samaritan Inpatient Rehabilitation Program Living at your full potential. Welcome When people are sick or injured, our goal is their maximum recovery. We help people live to their full potential.

More information

ENHANCING YOUR SKILLS IN STROKE QUALITY IMPROVEMENT & DATA ANALYSIS

ENHANCING YOUR SKILLS IN STROKE QUALITY IMPROVEMENT & DATA ANALYSIS ENHANCING YOUR SKILLS IN STROKE QUALITY IMPROVEMENT & DATA ANALYSIS Authors: Patricia Horstman, MSN, RN, NEA-BC Lynn Hundley, MSN, RN, APRN, CCRN, CNRN, CCNS Jeanie Luciano, MSN, RN, CRNP, CNRN, SCRN,

More information

What is the prior authorization process for Skilled Nursing Facility Admission?

What is the prior authorization process for Skilled Nursing Facility Admission? MyCare Long Term Care (LTC) Nursing Facility FAQs The nursing facility network is an essential part of the health care delivery system and we value your partnership. We appreciate the compassion you offer

More information

The Savvy PSC: Review of the 2014 Primary Stroke Certification Standards

The Savvy PSC: Review of the 2014 Primary Stroke Certification Standards The Savvy PSC: Review of the 2014 Primary Stroke Certification Standards Wendi J. Roberts RN, BA, MS, TNS, CLNC Field Director, Surveyor Management and Development Division of Accreditation and Certification

More information

ACUTE CARE TO REHABILITATION

ACUTE CARE TO REHABILITATION ACUTE CARE TO REHABILITATION JONATHAN P. QUEVEDO, M.D. JFK-JOHNSON REHABILITATION HOSPITAL PRESENTER DISCLOSURE INFORMATION JONATHAN P. QUEVEDO M.D. ACUTE CARE TO REHABILITATION FINANCIAL DISCLOSURE EMPLOYED

More information

JHS Stroke Program. 2016 JHS Annual Mandatory Education

JHS Stroke Program. 2016 JHS Annual Mandatory Education JHS Stroke Program 2016 JHS Annual Mandatory Education Learner Objectives At the conclusion of this module learners will be able to: State the definition of stroke Discuss the pathophysiology of stroke

More information

MEDICAL POLICY No. 91608-R1 MENTAL HEALTH RESIDENTIAL TREATMENT: ADULT

MEDICAL POLICY No. 91608-R1 MENTAL HEALTH RESIDENTIAL TREATMENT: ADULT MENTAL HEALTH RESIDENTIAL TREATMENT: ADULT Effective Date: June 4, 2015 Review Dates: 5/14, 5/15 Date Of Origin: May 12, 2014 Status: Current Summary of Changes Clarifications: Pg 4, Description, updated

More information

National Stroke Association s Guide to Choosing Stroke Rehabilitation Services

National Stroke Association s Guide to Choosing Stroke Rehabilitation Services National Stroke Association s Guide to Choosing Stroke Rehabilitation Services Rehabilitation, often referred to as rehab, is an important part of stroke recovery. Through rehab, you: Re-learn basic skills

More information

Acute Rehabilitation Center

Acute Rehabilitation Center Acute Rehabilitation Center Acute Rehabilitation Courtyard Our Center Community Westview Hospital's Acute Rehabilitation Center and programs are specially designed to meet the needs of our patients and

More information

Stroke Rehabilitation

Stroke Rehabilitation Stroke Rehabilitation Robert Teasell MD FRCPC Professor and Chair-Chief Dept Physical Medicine and Rehabilitation Schulich School of Medicine University of Western Ontario Lawson Health Research Institute

More information

Preparing Your Hospital for Primary Stroke Certification Authors: Wendy J. Smith, BS, MA, RES, RCEP, RN Claranne Mathiesen, MSN, RN, CNRN

Preparing Your Hospital for Primary Stroke Certification Authors: Wendy J. Smith, BS, MA, RES, RCEP, RN Claranne Mathiesen, MSN, RN, CNRN Preparing Your Hospital for Primary Stroke Certification Authors: Wendy J. Smith, BS, MA, RES, RCEP, RN Claranne Mathiesen, MSN, RN, CNRN Disclosures Wendy J. Smith-I have no actual or potential conflict

More information

Dedicated Stroke Interprofessional Rehab Team. Mixed Rehab Unit. Dedicated Rehab Unit

Dedicated Stroke Interprofessional Rehab Team. Mixed Rehab Unit. Dedicated Rehab Unit Outpatient & Community I n p a t I e n t Stroke Rehab Definition Framework Institutional Setting Inpatient Rehab in Acute Care or Rehab Hospitals* Acute Care Integrated Specialized Units Transitional Care

More information

Implementing a clustered acute stroke unit at a community hospital improves patient care

Implementing a clustered acute stroke unit at a community hospital improves patient care Implementing a clustered acute stroke unit at a community hospital improves patient care Linda Dykes, BScPT Manager, Sarnia Lambton District Stroke Centre Krista Steeves, BHScPT Physiotherapist, Bluewater

More information

Reducing Hospital Readmissions & The Affordable Care Act

Reducing Hospital Readmissions & The Affordable Care Act Reducing Hospital Readmissions & The Affordable Care Act The Game Has Changed Drastically Reducing MSPB Measures Chuck Bongiovanni, MSW, MBA, NCRP, CSA, CFE Chuck Bongiovanni, MSW, MBA, NCRP, CSA, CFE

More information

Presented by Kathleen S. Wyka, AAS, CRT, THE AFFORDABLE CA ACT AND ITS IMPACT ON THE RESPIRATORY C PROFESSION

Presented by Kathleen S. Wyka, AAS, CRT, THE AFFORDABLE CA ACT AND ITS IMPACT ON THE RESPIRATORY C PROFESSION Presented by Kathleen S. Wyka, AAS, CRT, THE AFFORDABLE CA ACT AND ITS IMPACT ON THE RESPIRATORY C PROFESSION At the end of this session, you will be able to: Identify ways RT skills can be utilized for

More information

Thrombolysis With Intravenous Tissue Plasminogen Activator Predicts a Favorable Discharge Disposition in Patients With Acute Ischemic Stroke

Thrombolysis With Intravenous Tissue Plasminogen Activator Predicts a Favorable Discharge Disposition in Patients With Acute Ischemic Stroke Thrombolysis With Intravenous Tissue Plasminogen Activator Predicts a Favorable Discharge Disposition in Patients With Acute Ischemic Stroke Nneka L. Ifejika-Jones, MD, MPH; Nusrat Harun, MSPH; Nareesa

More information

Sex Differences in Profiles & Outcomes of Patients with Traumatic Brain Injury in an Inpatient Rehabilitation Sample

Sex Differences in Profiles & Outcomes of Patients with Traumatic Brain Injury in an Inpatient Rehabilitation Sample Sex Differences in Profiles & Outcomes of Patients with Traumatic Brain Injury in an Inpatient Rehabilitation Sample Dr. Angela Colantonio Vincy Chan Tatyana Mollayeva Background & Significance Traumatic

More information

Factors Predicting Discharge Home From Inpatient Rehabilitation After Stroke

Factors Predicting Discharge Home From Inpatient Rehabilitation After Stroke May 5, 2009 Factors Predicting Discharge Home From Inpatient Rehabilitation After Stroke Summary This Analysis in Brief explores factors associated with discharge destination following stroke rehabilitation

More information

Marina Richardson, M.Sc. Deb Willems, BSc.PT David Ure, OT Robert Teasell, MD FRCPC

Marina Richardson, M.Sc. Deb Willems, BSc.PT David Ure, OT Robert Teasell, MD FRCPC Assessing the Impact of Southwestern Ontario s Community Stroke Rehabilitation Teams: An Economic Analysis Presenters: Laura Allen, M.Sc. (cand.) Matthew Meyer, Ph.D (cand.) Marina Richardson, M.Sc. Deb

More information

PREPARING THE PATIENT FOR TRANSFER TO AN INPATIENT REHABILITATON FACILITY (IRF) University Hospitals 8th Annual Neuroscience Nursing Symposium

PREPARING THE PATIENT FOR TRANSFER TO AN INPATIENT REHABILITATON FACILITY (IRF) University Hospitals 8th Annual Neuroscience Nursing Symposium PREPARING THE PATIENT FOR TRANSFER TO AN INPATIENT REHABILITATON FACILITY (IRF) University Hospitals 8th Annual Neuroscience Nursing Symposium May 31, 2013 2 DEFINITION: INPATIENT REHABILITATION FACILITY

More information

Kevin Saunders MD CCFP Rivergrove Medical Clinic Wellness Institute @ SOGH April 17 2013

Kevin Saunders MD CCFP Rivergrove Medical Clinic Wellness Institute @ SOGH April 17 2013 Kevin Saunders MD CCFP Rivergrove Medical Clinic Wellness Institute @ SOGH April 17 2013 Family physician with Rivergrove Medical Clinic Practice in the north end since 1985 Medical Director of the Wellness

More information

Atrius Health Pioneer ACO: First Year Accomplishments, Results and Insights

Atrius Health Pioneer ACO: First Year Accomplishments, Results and Insights Atrius Health Pioneer ACO: First Year Accomplishments, Results and Insights Emily Brower Executive Director Accountable Care Programs Emily_Brower@AtriusHealth.org November 2013 1 Contents Overview of

More information

PREVENTION WORKS: CDC Strategies for a Heart-Healthy and Stroke-Free America

PREVENTION WORKS: CDC Strategies for a Heart-Healthy and Stroke-Free America PREVENTION WORKS: CDC Strategies for a Heart-Healthy and Stroke-Free America DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR DISEASE CONTROL AND PREVENTION INTRODUCTION Prevention Works: CDC Strategies

More information

INSIGHT on the Issues

INSIGHT on the Issues INSIGHT on the Issues AARP Public Policy Institute Medicare Beneficiaries Out-of-Pocket for Health Care Claire Noel-Miller, PhD AARP Public Policy Institute Medicare beneficiaries spent a median of $3,138

More information

Ontario Stroke System. Prepared by: Stroke Rehabilitation Evaluation Working Group Stroke Evaluation Advisory Committee May, 2007

Ontario Stroke System. Prepared by: Stroke Rehabilitation Evaluation Working Group Stroke Evaluation Advisory Committee May, 2007 Ontario Stroke System Stroke Rehabilitation Performance Measurement Manual Prepared by: Stroke Rehabilitation Evaluation Working Group Stroke Evaluation Advisory Committee May, 2007 Stroke Rehabilitation

More information

Fall 2013. A progress report on improving rehabilitative care in Waterloo Wellington

Fall 2013. A progress report on improving rehabilitative care in Waterloo Wellington Fall 2013 A progress report on improving rehabilitative care in Waterloo Wellington The Waterloo Wellington Rehabilitative Care Council Improving rehabilitative care in Waterloo Wellington, fall 2013,

More information

ACUTE STROKE PATHWAY

ACUTE STROKE PATHWAY ACUTE STROKE PATHWAY THERE IS A NEED FOR STATEWIDE STROKE SYSTEM OF CARE ALL MISSISSIPPIANS SHOULD BE ABLE TO ACCESS NEW PROTOCOLS FOR STROKE TREATMENT JOINT EFFORT WITH EMS, PHYSICIANS, HOSPITALS AND

More information

Physician and other health professional services

Physician and other health professional services O n l i n e A p p e n d i x e s 4 Physician and other health professional services 4-A O n l i n e A p p e n d i x Access to physician and other health professional services 4 a1 Access to physician care

More information

Managing Patients with Multiple Chronic Conditions

Managing Patients with Multiple Chronic Conditions Best Practices Managing Patients with Multiple Chronic Conditions Advocate Medical Group Case Study Organization Profile Advocate Medical Group is part of Advocate Health Care, a large, integrated, not-for-profit

More information

Henry Ford Macomb Hospitals. Inpatient. Patient and Family Handbook

Henry Ford Macomb Hospitals. Inpatient. Patient and Family Handbook Henry Ford Macomb Hospitals Inpatient Rehabilitation Patient and Family Handbook Welcome At Henry Ford Macomb Hospitals, our goal is to help you become as independent as possible while achieving your

More information

3/16/2016. Preventing Readmissions Through Compliant Patient Transitions. Transition of Care Statistics. Care Transitions The Regulatory Environment

3/16/2016. Preventing Readmissions Through Compliant Patient Transitions. Transition of Care Statistics. Care Transitions The Regulatory Environment Preventing Readmissions Through Compliant Patient Transitions Deborah L. Carlino, RN, MBA, CHC, CHRC Director of Healthcare Compliance and Audit - Rutgers, The State University of New Jersey Melanie A.

More information

nicheprogram.org 16th Annual NICHE Conference Forging New Paths and Partnerships 1

nicheprogram.org 16th Annual NICHE Conference Forging New Paths and Partnerships 1 Use of the Palliative Performance Scale Version 2 (PPSv2) in Obtaining Palliative Care Consults Patrice Fedel MS, RN, BC Objectives At the end of this presentation the learner will be able Identify patients

More information

2014: Volume 4, Number 1. A publication of the Centers for Medicare & Medicaid Services, Office of Information Products & Data Analytics

2014: Volume 4, Number 1. A publication of the Centers for Medicare & Medicaid Services, Office of Information Products & Data Analytics 2014: Volume 4, Number 1 A publication of the Centers for Medicare & Medicaid Services, Office of Information Products & Data Analytics Medicare Post-Acute Care Episodes and Payment Bundling Melissa Morley,¹

More information

Where Should Rehabilitation Take Place?!

Where Should Rehabilitation Take Place?! Where Should Rehabilitation Take Place?! Three Basic Questions! 1. Is rehabilitation effective in improving a patient s functional abilities?!yes" yes" 2. Is rehabilitation cost effective?!yes" where"

More information

Becoming a Comprehensive Stroke Center: A Guide to Certification

Becoming a Comprehensive Stroke Center: A Guide to Certification Becoming a Comprehensive Stroke Center: A Guide to Certification Lori M. Massaro, MSN, CRNP Clinical Supervisor Univ of Pittsburgh Medical Center Stroke Institute Disclosure Speakers Bureau Genentech,

More information

Rehabilitation Center

Rehabilitation Center Rehabilitation Center PATIENT INFORMATION Welcome to Ministry Saint Joseph s Hospital At Ministry Health Care, we earn trust by working together as One Ministry to keep PATIENTS FIRST in everything we

More information

Timing it Right to Support Families as they Transition

Timing it Right to Support Families as they Transition Timing it Right to Support Families as they Transition Jill Cameron, PhD Canadian Institutes of Health Research New Investigator Assistant Professor Adjunct Scientist, Toronto Rehabilitation Institute

More information

Bryant T. Aldridge Rehabilitation Center Unit Specific Inclusive Diversity Analysis: CULTURAL COMPETENCY AND DIVERSITY PLAN February 2015

Bryant T. Aldridge Rehabilitation Center Unit Specific Inclusive Diversity Analysis: CULTURAL COMPETENCY AND DIVERSITY PLAN February 2015 Bryant T. Aldridge Rehabilitation Center Unit Specific Inclusive Diversity Analysis: CULTURAL COMPETENCY AND DIVERSITY PLAN February 2015 Prepared by Brian Agan A Cultural Competency and Inclusive Diversity

More information

Medical Records Law: Regulatory Issues Meaningful Use? EHR v. EMR

Medical Records Law: Regulatory Issues Meaningful Use? EHR v. EMR Medical Records Law: Regulatory Issues Meaningful Use? EHR v. EMR Conrad Meyer JD MHA FACHE Health Care Section Chair Chaffe McCall, LLP cmeyer@chaffe.com (504) 585-7067 6/20/2011 McCall 1 Introduction

More information

Out of Sight, Out of Mind? Post Acute Strategies for Stroke Care Disclosures

Out of Sight, Out of Mind? Post Acute Strategies for Stroke Care Disclosures Out of Sight, Out of Mind? Post Acute Strategies for Stroke Care Kathy Morrison, MSN, RN, CNRN, SCRN Alicia Richardson, MSN, RN, ACCNS-AG Kari Moore, MSN, AGACNP-BC Disclosures Kathy Morrison Kari Moore

More information

ESC/EASD Pocket Guidelines Diabetes, pre-diabetes and cardiovascular disease

ESC/EASD Pocket Guidelines Diabetes, pre-diabetes and cardiovascular disease Diabetes, prediabetes and cardiovascular disease Classes of recommendations Levels of evidence Recommended treatment targets for patients with diabetes and CAD Definition, classification and screening

More information

Medicare Beneficiaries Out-of-Pocket Spending for Health Care

Medicare Beneficiaries Out-of-Pocket Spending for Health Care Insight on the Issues OCTOBER 2015 Beneficiaries Out-of-Pocket Spending for Health Care Claire Noel-Miller, MPA, PhD AARP Public Policy Institute Half of all beneficiaries in the fee-for-service program

More information

Admission to Inpatient Rehabilitation (Rehab) Services

Admission to Inpatient Rehabilitation (Rehab) Services Family Caregiver Guide Admission to Inpatient Rehabilitation (Rehab) Services What Is Rehab? Your family member may have been referred to rehab after being in a hospital due to acute (current) illness,

More information

HITECH Act Update: An Overview of the Medicare and Medicaid EHR Incentive Programs Regulations

HITECH Act Update: An Overview of the Medicare and Medicaid EHR Incentive Programs Regulations HITECH Act Update: An Overview of the Medicare and Medicaid EHR Incentive Programs Regulations The Health Information Technology for Economic and Clinical Health Act (HITECH Act) was enacted as part of

More information

Clarification of Patient Discharge Status Codes and Hospital Transfer Policies

Clarification of Patient Discharge Status Codes and Hospital Transfer Policies The Acute Inpatient Prospective Payment System Fact Sheet (revised November 2007), which provides general information about the Acute Inpatient Prospective Payment System (IPPS) and how IPPS rates are

More information

What do these stories illustrate about ER/ALC issue?

What do these stories illustrate about ER/ALC issue? What do these stories illustrate about ER/ALC issue? Maximizing the Impact of Rehab on Provincial Priority Issues Mark Bayley, MD, FRCPC Medical Director, Neuro Rehabilitation Program, Toronto Rehab and

More information

There are 5 demographic data elements that include gender, date of birth, race, ethnicity status,

There are 5 demographic data elements that include gender, date of birth, race, ethnicity status, Demographic and Data s There are 5 demographic data elements that include gender, date of birth, race, ethnicity status, and postal code of the patient. These elements are intended to be collected once

More information

A Phase II RCT of Stroke Navigators to Improve Compliance with Secondary Stroke Prevention: PROTECT DC

A Phase II RCT of Stroke Navigators to Improve Compliance with Secondary Stroke Prevention: PROTECT DC A Phase II RCT of Stroke Navigators to Improve Compliance with Secondary Stroke Prevention: PROTECT DC Alexander W. Dromerick, MD National Rehabilitation Hospital Georgetown University Departments of Neurology

More information

Danbury Public Schools 63 Beaver Brook Rd. Danbury, CT 06810. 2. Family Member s Name (if different from employee):

Danbury Public Schools 63 Beaver Brook Rd. Danbury, CT 06810. 2. Family Member s Name (if different from employee): 1. Employee s Name: 2. Family Member s Name (if different from employee): 3. The attached sheet describes what is meant by a serious health condition under the Family and Medical Leave Act. Does the patient

More information

STROKE PREVENTION AND TREATMENT MARK FISHER, MD PROFESSOR OF NEUROLOGY UC IRVINE

STROKE PREVENTION AND TREATMENT MARK FISHER, MD PROFESSOR OF NEUROLOGY UC IRVINE STROKE PREVENTION AND TREATMENT MARK FISHER, MD PROFESSOR OF NEUROLOGY UC IRVINE CASE REPORT: ACUTE STROKE MANAGEMENT 90 YEAR OLD WOMAN, PREVIOUSLY ACTIVE AND INDEPENDENT, CHRONIC ATRIAL FIBRILLATION,

More information

Who Should Have an AF Ablation?

Who Should Have an AF Ablation? Knowledge is Power! In order to help you make the best decisions about AF ablation, we want you to be knowledgeable about your AF and our ablation outcomes The following presentation provides information

More information

A Guide to Understanding Your Discharge Options After Hospitalization

A Guide to Understanding Your Discharge Options After Hospitalization A Guide to Understanding Your Discharge Options After Hospitalization DHMC Care Management: (603) 650-5789 Table of Contents Hospital to Home with Home Care... 3 Hospice Care... 5 Skilled Nursing Facility*...

More information

Annual Certified Primary Stroke Center Luncheon

Annual Certified Primary Stroke Center Luncheon Welcome to the American Heart Association/American Stroke Association & The Joint Commission s Annual Certified Primary Stroke Center Luncheon International Stroke Conference 2013 Thursday, February 7,

More information