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1 Brain injury and neuro-rehabilitation services focused on recovery.

2 Inpatient, outpatient and therapy services Milwaukee Center for Independence Nexday programs provide a continuum of care for people recovering from a brain injury or stroke, or who require rehabilitative services due to disability, muscular dystrophy, cerebral palsy, ALS or other neurological disease or disorder. Nexday s services and treatments are built on a foundation of evidenced-based care and research to effect recovery and positive outcomes in a three-tiered approach: Functional Independence Measure Nexday BIRC average 6-month gains BEFORE AFTER Nexday Brain Injury Rehab Center at Wellspring provides post-acute inpatient care that bridges the gap between hospital and home. Nexday Outpatient Services provides community-based outpatient services that treat the whole person and incorporate family and community into recovery. MCFI Therapy Agency provides customized therapies, including aquatic therapy, resulting in greater independence following an injury, disease or disorder. FIM SCORE COGNITIVE DRESSING (UPPER) DRESSING (LOWER) BATHING EATING Nexday BIRC at Wellspring uses the Functional Independence Measure, which measures motor skills and cognitive progress. It is the most widely accepted assessment in use in the inpatient rehabilitation community. An expert team of medical and rehabilitation professionals working with patients to achieve greater independence.

3 Post-Acute Inpatient Care Nexday Brain Injury Rehab Center at Wellspring is an 18-bed unit treating the whole person using a person-centered, interdisciplinary team approach. All services are designed to improve functional abilities and carry over into the client s life after discharge. We serve clients who: Are not ready to go home from the hospital setting Are 15 years of age and older * Need assistance with physical, cognitive and/or emotional functioning as a result of a brain injury Need to develop skills so they can return to the community Our experienced interdisciplinary team includes: A dedicated team of doctors, including a physiatrist Nursing staff specializing in rehabilitation services A social worker/case manager who coordinates services and discharge planning A skilled therapy team Brain injury rehabilitation therapists A full range of services are provided, including: 24/7 specialized clinical support team Two or more hours of therapy five days a week Physical, occupational and speech therapies Psychological and/or psychiatric counseling Vocational evaluation, counseling and training Recreational therapy and social activities Nutrition guidance by a registered dietitian Community reintegration Daily living skills training Individual and group therapy sessions Aquatic therapy and therapeutic horseback riding Support, education and training for families and caregivers Monthly support groups We accept Medicaid, Medicaid HMO, private insurance, Workers Compensation and private pay. WENDI s Story After getting dizzy and falling down the steps at her apartment building, Wendi Mammel not only suffered a brain injury, but a stroke. She remained in the hospital for two months, where a portion of her skull was removed to relieve pressure on the brain. When Wendi was moved to a skilled nursing facility, her initial prognosis was that she was not likely to ever walk again. But within that facility was the Brain Injury Rehab Center, and the center s skilled staff worked closely with Wendi for the next 10 months. Over time, Wendi graduated from using a wheelchair to a walker and then a cane. She received physical therapy, occupational therapy and speech therapy. She also received recreational therapy, psychology services and participated in activities at BIRC. Wendi believes that intensive daily care is the reason for the progress she s made. She learned strategies at BIRC to help her keep moving forward: I think I m better at expressing myself to people, and my walking is much better, said Wendi, who now lives independently. I shower by myself. I make my own meals. It s kind of cool. * Clients who are 15 to 18 years old have private rooms and 24-hour visitation is allowed. We coordinate with local schools so students can continue their education.

4 NEXDAY Outpatient Services Nexday Outpatient Services interdisciplinary team of brain injury rehabilitation specialists provides community-based outpatient services and treatment in one convenient location. Our expert staff provides individual care so specific recovery goals are met. Our team collaborates with physicians and other providers, and educational resources are available for clients, caregivers and families. JOHNNY S Story At a family reunion, Johnny Gratz mistook the basement door for the bathroom door. He tumbled down the stairs, banging his head on the concrete landing below. I was bleeding all over the place, he said. I wound up in a coma for about a week. They told my daughter I wasn t going to make it. But our family believes in prayer, believes in God. Five days later, his daughter saw his finger move. From then on, it was just a journey of recovery, she said. Johnny had to have a bone flap removed to relieve pressure on his brain and another operation to repair internal damage from the fall. His daughters found the ideal place for his ongoing rehabilitation the Brain Injury Rehab Center. At BIRC, Johnny participated in a number of therapies. I saw what they were trying to do for me get my cognitive functioning back, he said. Three years after his fall, he still has some pain, and his organizational skills aren t what they used to be, but he has come a long way. All in all, I m doing phenomenally, he said. Nexday serves individuals who are: Recovering from a traumatic or acquired brain injury Recovering from a stroke Recovering from a work-related injury Requiring short-term outpatient therapies Looking for a return-to-work plan Services available at Nexday include: Intensive rehabilitation Clinical management Medication management Coping with cognitive fatigue Restore/improve cognitive functioning Restore understanding of abstract or complex languages Therapies Physical therapy Occupational therapy Speech therapy Aquatic therapy Neurologic music therapy Art and horticultural therapies Therapeutic bathing services Therapeutic recreation Behavioral health Neuropsychological testing Personal counseling Parenting groups Group meetings Coping skills development

5 Community and social reintegration Stress management Coping with stimulus overload Social interaction skill building Daily Living Skills group Support for families and caregivers Wellness Aerobic conditioning Physical strengthening Health and nutrition education Supportive services Developing a support network Education, support and training for caregivers and employers Family resources and training Employment/vocational rehabilitation Vocational evaluation and counseling Benefits analysis and counseling Community-based assessment Work-readiness training and preparation Employer access and interaction Return-to-work strategy Robert s Story When Robert Peterson was hit by a car, resulting in a traumatic brain injury, his life took a dramatic turn. Before his injury, Robert liked to be outdoors, ride his bike and cook he had been employed as a cook after earning a culinary arts certificate from the Milwaukee Area Technical College. After his accident, though, Robert had issues with memory, irritability and impulse control, and he was not able to sustain employment for any length of time. That s when Robert became involved with MCFI LIFE Services, where staff members helped him get involved in community activities such as bowling and swimming. He started to meet new people and develop friendships, and he began to thrive. In 2013, Robert transferred to the MCFI Nexday brain injury recovery program, where he re-learned coping, organizational and planning skills. Today, Robert is living independently in the community, has improved relationships and is involved with several social and recreational activities. Robert has also been able to maintain employment in the hospitality field and is even involved in training new employees.

6 Therapies MCFI Therapy Agency works with people of all ages, from children to older adults, providing customized one-on-one care and advanced techniques to treat specific conditions for those with: Physical disabilities or injuries Developmental disabilities Chronic and complex medical conditions Stroke, brain injury and neurological disorders or diseases To begin treatment, we will need an order from your physician and your medical records. Then you will receive a thorough assessment. You, your family and other care providers will be involved in developing a plan based on your personal needs and goals. Progress on your goals will be evaluated weekly by our team of clinical therapists, including: Physical medicine and rehabilitation doctor Aquatic therapist Physical therapist Physical therapy assistant Occupational therapist Speech pathologist Neuropsychologist Our team provides the following specialized services: Therapies Occupational therapy Physical therapy Speech therapy Aquatic therapy Motor skills rehabilitation Help with balance and dizziness Fall-prevention training Help with fine motor coordination Flexibility training Spasticity and contracture management Strength and endurance training Upper extremity splinting Cognitive rehabilitation Adult sensory processing disorder assistance Cognitive skills development Daily living skills training Activities of daily living and home-management training Assistive-device consultation and training Other services Pain management techniques Visual motor integration Voice and swallowing Therapy agency hours are 8:30 a.m. to 4 p.m. Monday through Friday, and we accept all insurance plans. Speech pathologist

7 Common Effects of Brain Injury Although every person who has a brain injury is unique, there are some common characteristics among those who have experienced a brain injury: Changes in memory, particularly short-term memory loss Personality changes, such as a tendency to anger easily Emotions seem closer to the surface Communication difficulties, such as the inability to remember certain words, or confusing similar-sounding words Visual challenges Recurring headaches Physical and mental fatigue Sleeping problems Difficulty concentrating Sensitivity to noise and light An experienced interdisciplinary team is able to identify these effects and develop a personalized plan to help the patient overcome the challenges and progress toward recovery. Leading Causes of TBI Source: Centers for Disease Control 10.7% Assaults 14.3% MOTOR VEHICLE TRAFFIC 15.5% STRUCK BY/ AGAINST 19.0% OTHER 40.5% FALLS What is neuroplasticity? The brain has an amazing ability to adapt to new experiences and environments, and learn new skills. It has the capacity to create new connections and re-wire itself, a property known as neuroplasticity. Nexday BIRC at Wellspring, Nexday and Therapy Agency are service lines of the Milwaukee Center for Independence, which serves more than 8,500 people every year. MCFI has been providing superior services and helping people with disabilities and disadvantages move through challenge to triumph for more than 75 years. MCFI s program areas are: Neuro-rehabilitation Behavioral Health Children s Programs Employment Services Home Care Long-Term Care Nutrition Services

8 Contact: Brain Injury Rehab Center at Nexday BIRC at Wellspring Inpatient 9350 W. Fond du Lac Ave. Milwaukee, WI FAX: Nexday Brain Injury Recovery Outpatient 3333 S. Howell Ave. Milwaukee, WI FAX: Visit us at Therapy Agency MCFI Main Campus 2020 W. Wells St. Milwaukee, WI

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