JointVenture. World Class Care. From The Editor. Welcome. Bayhealth Patients Now Have Access To Penn Orthopaedic Physicians.

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1 JointVenture A Co m m u n i c a t i o n s Ne w s l e t t e r F o r Ba y h e a l t h Pa t i e n t s Wi n t e r 2011 From The Editor World Class Care Bayhealth Patients Now Have Access To Penn Orthopaedic Physicians Welcome In this issue we unveil 2 milestones within Bayhealth Orthopaedics; the announcement of our new Bayhealth Orthopaedic Medical Director, Dr. Stephen Manifold and our partnership with Penn Orthopaedics. We also explore how our inpatient rehab center can assist patients with improved functional abilities after a stroke. We also give tips on how to easily access our high quality outpatient rehab services. We conclude with new changes to Medicare that impact Home Care services. Brad D. Kirkes, MBA, MHA, OTR/L, CHT Administrative Director, Operations- Orthopaedics and Neurosciences Bayhealth patients now have access to some of the world s top orthopaedic physicians, thanks to a new partnership between Bayhealth and Penn Orthopaedics Medicine. U.S. News and World Report recognizes Penn Orthopaedics as one of the nation s top hospitals for orthopaedic care. Penn Orthopaedics established the world s first orthopaedic surgery department in In addition, U.S. News and World Report ranks the Hospital of the University of Pennsylvania one of the top ten hospitals in the United States overall. This is the first time Penn Orthopaedics has partnered with any health system in the region. Bayhealth is already affiliated with the University of Pennsylvania Cancer Network and Penn Medicine Cardiovascular Surgery. Continued on page 3 Bayhealth Kent General l Milford Memorial

2 Bayhealth Appoints Orthopaedics Medical Director Stephen Manifold, M.D., has been appointed as the new Orthopaedic Medical Director for the Bayhealth Orthopaedics & Rehabilitation Service Line. In this newly created position, Dr. Manifold will lead Bayhealth Orthopaedics and help ensure consistent and high quality care. Dr. Manifold will work closely with Bayhealth orthopaedic surgeons, nurses, therapists and other clinical professionals to provide the best possible outcomes for orthopaedics patients through evidence-based medicine. Dr. Manifold s experience, vision and insight will help us continue to develop Bayhealth Orthopaedics into a worldclass program. Ultimately, our patients will benefit from his leadership, said Orthopaedics and Neurosciences Administrative Director Brad Kirkes. We ll continue to improve our program based on evidence-based practices. These are medical protocols and standards that have been documented as having the best patient outcomes, said Dr. Manifold. Dr. Manifold completed his undergraduate degree from Temple University and earned his medical degree from the Temple University School of Medicine. He received his orthopaedic surgery residency at The New York Orthopaedic Hospital/Columbia-Presbyterian Medical Center. He completed his fellowship in knee reconstruction and sports medicine at The Insall Scott Kelly Institute at Beth Israel Medical Center in New York City. Dr. Manifold has been a board-certified orthopaedic surgeon in private practice for 11 years, serving on the medical staff for both hospitals. He has served on a number of Stephen Manifold, M.D committees including Infection Control, Trauma, Surgical Services Executive Committee and the Surgical Operations Workgroup. Reintegration After Stroke Each year, according to the American Heart Association, approximately 795,000 people suffer a stroke. Mortality rates have declined in recent years due to earlier and more accurate diagnosis and better acute care. However, persisting disabilities lead to partial or total dependence in activities of daily living in percent of stroke survivors. Timely rehabilitation can minimize these disabilities. The goal of the Inpatient Rehabilitation Program is to return such patients home at their highest functional level possible. For those patients returning to an independent setting, help from family 2 members or other caregivers is often critical to achieving successful long-term outcomes. Physical issues that need to be assessed include: the success of the patient in adapting to the living environment and his/her ability to function independently, the patient s adherence to medical and rehabilitation regimens, swallowing precautions, nutrition and hydration, and prevention of skin breakdown. As important as the physical state of the patient, his/her mental state must also be examined. Depression occurs in percent of patients following a stroke. It can range from minor symptoms to major depression. The coping mechanisms of the family/ caregivers are also at risk and should be monitored, not only for their well-being, but to ensure that the stroke survivor is provided the comfort, safety, and dignity he or she needs. Bayhealth Milford Inpatient Rehabilitation begins addressing discharge issues early in the patients stay. Primarily, this is done through patient/ family education and training that focuses on tasks that will need to be preformed after discharge. The patient s residence may be evaluated for safety and accessibility, and proposed modifications may be offered. At discharge, arrangements are made for necessary equipment, home health or outpatient therapy, lab draws, nursing services, wound care, appropriate medications, support groups and medical follow-up. All of these arrangements are written on a plan of continued care and given to the patient/family upon discharge. When problems are detected after discharge from inpatient rehabilitation, services should be considered that help the patient maintain the gains he/she made in the inpatient setting and that build on the family s strengths. The patient s primary care physician can assist with much of this coordination. For more information on the services available to stroke survivors, please contact Bayhealth Milford Inpatient Rehabilitation at Bayhealth JointVenture

3 Current Treatment of Lower Extremity Lymphedema One in 30 people have lymphedema worldwide. So what is it? Lymphedema is the accumulation of high protein fluid resulting from impairment to the lymphatic system. One of the lymphatic system s main functions is to drain and transport interstitial fluid into the venous system. Sometimes treatments for cancer such as surgery to remove lymph nodes and radiation reduce the efficiency of the lymphatic system and as a result lymphedema develops. Breast cancer patients may present with lymphedema of their arm on the operated side. Lymphedema may also occur in the legs of patients that have received procedures to treat cancer of their legs. In the case of lower extremity lymphedema, patients usually report slow progressive swelling usually first in the toes. Patients note increase in the heaviness, achiness and some report minimal pain or discomfort. When lower extremity lymphedema persists for a long period of time, thickening of the skin is noted, discoloration of the skin and often skin lesions such as ulcerations and rashes appear. Patients will generally recognize that one leg just looks different from the other. Lymphedema is a treatable condition. Before Physical Therapy is initiated, it is important that the patient with lymphedema be first evaluated by their physician. All infections need to be identified and treated before therapy is initiated. The most common treatments include bandaging, manual lymphatic drainage (form of massage), the use of compression pumps and gentle exercise. Following a thorough assessment, your physical therapist will design a treatment plan specific to each patients need with emphasis on home instructions for daily management. If you should require treatment of lymphedema of either your arm or leg, please call the Physical Therapy staff at Milford Hospital ( ). World Class Care Continued from page 1 What does the new Bayhealth-Penn Orthopaedics partnership mean for you? n Penn Orthopaedics residents will be here at Kent General and Milford Memorial to provide you care. These are fourth year orthopaedic residents with specialized expertise in orthopaedic and orthopaedic trauma. n Bayhealth orthopaedic surgeons will also have a special physician-tophysician relationship with surgeons at Penn Orthopaedics in Philadelphia. The Penn surgeons will share their expertise and offer an expeditious transfer to Penn for special orthopaedic cases. n This partnership will help Bayhealth continue its development of evidencebased clinical protocols for Bayhealth Orthopaedic patients. Evidence-based protocols are medical practices that have been documented as providing the fewest complications and the best clinical outcomes for patients. n There will be opportunities for Bayhealth orthopaedic surgeons to be involved in Penn Medicine teaching conferences and other continuing education offerings. Bayhealth orthopaedic surgeons will keep pace with the latest and most cutting-edge techniques in orthopaedic surgery. n The new partnership will enable Bayhealth to continue its efforts to recruit the best and brightest physicians to our medical staff. Surgeons prefer to be affiliated with an academic medical center, and our partnership will help us attract the top doctors to Bayhealth for your care. The Bayhealth Speech Pathology Department hosted a table at the January 29 Bayhealth Baby Fair. 3

4 From Here to There Navigating the rough waters after an illness or injury can be tough. But if outpatient therapy is in the cards for you, there are people who can help. Bayhealth offers outpatient therapy centers in Dover and Milford. Each center offers Physical Therapy, Occupational Therapy and Speech Language Pathology services. But how does a person access the services and get from Here to There? All outpatient therapy services must start with a prescription from a referring physician. Then a referral is made to the appropriate center depending on where the person lives. From there, our front office staff will take over. An important piece of the puzzle that is needed before the first visit is to confirm the person s insurance status. This can be a grueling task at times, but the front office staff is always there to assist you with the process. The front office at the Outpatient Rehabilitation Center in Dover is managed by the Front Office Coordinator, Kathy Matthews. Kathy is assisted by Registrar/Patient Access Specialists Edie Peterman and Kasey Mears. They are cross trained in all aspects of preparing a patient appointment for therapy. The front office at the Outpatient Rehabilitation 4 Center in Milford is managed by Office Coordinator, Doreen Moore. She is assisted by Department Secretary Beverly Isaacs. Our friendly front office staffs will ensure that the patient, family and caregivers are completely satisfied with the therapy experience. Following the initial evaluation or first day of therapy, the front office staff continues to play an important role. They will help the patient and family set up a therapy schedule that works with their personal schedule. For those patients who are being treated by all three therapy disciplines, the front office will attempt to coordinate the therapy appointments back to back on the same day to make coming to therapy easy for the patient and family. The entire staff does their best to accommodate any special requests from the patient. If you are in need of outpatient therapy services look no further then the Outpatient Rehabilitation Centers at Bayhealth. Call to speak to the front office staff at Kent General in Dover. Call to speak to the front office staff at Milford Memorial in Milford. Kent campus staff ( l to r) Kasey Mears, Edie Peterman and Kathy Matthews. Milford campus staff Bev Isaacs (front) and Doreen Moore. Bayhealth employees who utilize Bayhealth Therapy Centers pay a reduced co-pay compared to other in-network therapy facilities. Bayhealth JointVenture

5 A New Medicare Law for Home Care Face to Face Encounter With the Affordable Care Act of March 23, 2010, comes new Medicare Laws. Beginning early in 2011 Medicare is requiring your physician order home health care based on personal examination of the patient. The law requires that physicians perform a face to face encounter to certify eligibility for home health services. This means that the physician must have seen the patient referred to Home Care 90 days prior or 30 days after the start of Home Care services. The overall goal of the Affordable Care Act provision is to obtain greater physician accountability in certifying a patient s eligibility and overseeing a patient s medical treatment. The law does allow for the Nurse Practitioner (NP) or the Physician s Assistant (PA) to provide the face to face encounter providing the NP or the PA is working for or in collaboration with the physician. During the face to face encounter, documentation must be presented describing how the patient s clinical condition supports them being homebound and thus the need for skilled services. Medicare does allow the hospitalist to provide the face to face encounter to certify the need for home health, initiate the orders for home health, and then hand off the patient to a community based physician. For 2011 the Face to Face requirement is part of the Home Care certification process. A new Home Care form has been devised to capture all the Medicare requirements. This form will be available for use by the end of January. If you have any questions about this new law you can visit the Medicare website at www. cms.gov or you can contact the Home Care office at

6 Ortho Rehab News Introducing Tiffany Floyd New Administrative Assistant Tiffany comes to Bayhealth with Administrative experience from Temple University Department of Cardiology and University of Pennsylvania Office of Research Services/Grants and Proposal. Tiffany spent most of her years in Philadelphia area and relocated to Dover in March She enjoys reading, shopping, and helping others. She provides administrative support for Brad Kirkes in Orthopedics/Neuroscience and Donna Stinson in Oncology Services. Welcome Back Shawn Schlegel, PT, COMT Shawn returns to Bayhealth as the Lead Physical Therapist in Inpatient/Outpatient Rehabilitation at Milford. Shawn previously served as the Lead Physical Therapist in Outpatient Rehabilitation at Kent. He has been recently working in North Carolina as a Physical Therapist in private practice. The rehab team welcomes Shawn back to Bayhealth. Welcome New Rehab Staff The Rehab Team at Kent welcomes new therapy staff (pictured below, l - r): Courtney Nice, DPT, from the Physical Therapy Department; Ashley Garey, MS, CF-SLP, from the Speech Pathology Department; Melissa Lim, DPT, from the Physical Therapy Department and Natalie Barnes, OTR, from the Occupational Therapy Department. 6 Bayhealth JointVenture

7 Important Phone Numbers for Orthopaedic Physicians and Ortho Rehab Departments BAYHEALTH ORTHOPAEDIC PHYSICIANS BAYHEALTH ORTHO REHAB DEPARTMENTS Phone/Fax Richard DuShuttle, MD Kent Milford Fax Hamilton Easter, MD Kent Fax Stephen Malone, MD Kent Fax Stephen Manifold, MD Kent Milford Michael Mattern, MD Kent Fax Lawrence Piccioni, MD Kent Fax Glen Rowe, MD Kent Fax Phone Charlene Bieber, Director Home Care Effie Elliott, Manager PT/OT Kent General Kim Jester, Manager PT/OT Milford Memorial Outpatient Rehab Center Front Desk, Kent General Front Desk, Milford Memorial Rob Uebele, Director Inpatient Rehabilitation Meredith Sullivan, Manager Speech Pathology, Kent General/Milford Memorial Eric Schwartz, MD Kent Fax Steven Tooze, MD Kent Nelson Wiegman, MD Milford Fax

8 Bayhealth Medical Center does not discriminate against any person on the basis of race, color, national origin, disability, or age in admission, treatment, or participation in its programs, services and activities, or in employment. Contact Person/Section 504 Coordinator: Jo Ann Davis Telephone Number: (302) TDD or State Relay number: Bayhealth TDD # is Bayhealth Kent General l Milford Memorial 8 Bayhealth JointVenture

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