Patient Guide. New Hanover Health Network. Coastal Rehabilitation Services

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1 Patient Guide New Hanover Health Network Coastal Rehabilitation Services

2 Welcome This guide book is designed to provide you with information regarding the programs, treatment and care provided by Coastal Rehabilitation Services. As part of the wide range of services available at New Hanover Health Network, Coastal Rehabilitation Services offers an advanced level of inpatient and outpatient rehabilitative care for people in Southeastern North Carolina. You, or someone you care about, have an injury, illness or disease that has changed your ability to do things for yourself. The programs of Coastal Rehabilitation Services are designed to help you learn to be as independent as you can be. We welcome your comments and suggestions. Please feel free to call on any member of our staff for assistance. The number is Our Mission To assist people with functional limitations in achieving and maintaining the highest possible level of independence through evaluation, treatment and education. To enhance the quality of life, promote community and vocational reintegration, and serve as an advocate for the individuals needs. Coastal Rehabilitation 2

3 Programs The changes you have experienced are difficult, and you will have rehabilitation specialists working with you to help you to adjust and learn ways to be more independent. Depending on your goals you may practice walking, getting around with an assistive device, getting in and out of a car, grooming, bathing, dressing, eating, toileting and speaking, as well as activities to improve your thinking, problem solving, decision making and social interaction. Acute Care Rehabilitation Services: You may have the opportunity to begin your rehabilitation program while in the acute care hospital at New Hanover Regional Medical Center or at Cape Fear Hospital. Our team of physical, occupational, and/or speech therapy professionals may work with you to begin your recovery from injury or illness. Inpatient Services: You will have your own team of rehabilitation specialists working with you on a 24-hour basis to learn ways to be more independent. Coastal Rehabilitation 3

4 Day Program Options: You will spend your evenings and nights at home. During the day, you will work with your own team of rehabilitation specialists to learn ways to be more independent. Your individual schedule will be designed to match your goals. Outpatient Services: Outpatient services can range from a few hours once a week to several hours each day. Usually an individual comes for outpatient services to work on a specific problem area. Coastal Rehabilitation 4

5 Our Philosophy of Care The staff of Coastal Rehabilitation Services are committed to providing the highest quality of rehabilitative care by: Providing a continuum of accessible care from prevention to follow-up for rehabilitative services. Enhancing the quality of life, facilitating community reintegration and advocating our patients rights. Providing patient-centered personal care with the family or support base as an integral part in the rehabilitative process. Working collaboratively as an interdisciplinary team to assess, plan, implement and evaluate the rehabilitative process to meet the patients holistic needs. Providing patient and family education that focuses on achieving functional outcomes and facilitating wellness. Promoting teamwork, communication and decision-making within the interdisciplinary program model to create a positive work environment for employees. Empowering staff to seek out and implement performance improvement activities. Coastal Rehabilitation 5

6 Providing education for staff development and ensuring clinical competence and expertise. Promoting a collaborative role within rehabilitation sites and across the health care system. Acting with absolute honesty, integrity and fairness in the way we conduct business and the way we live our lives. Trusting our colleagues as valuable members of our health care team and pledging to treat one another with loyalty, respect and dignity. Providing quality care as measured through outcomes. Utilizing cost-effective measures to provide financially responsible care. Maintaining or exceeding our customer expectations and the standards of rehabilitative care for accreditation by the Joint Commission on Accreditation of Healthcare Organizations and the Commission on Accreditation of Rehabilitation Facilities. Serving as a resource, facilitator and advocate for all in need of rehabilitation services, from community service programs promoting wellness and injury prevention, to caring for those who have experienced devastating injuries or illness and resultant disability. Coastal Rehabilitation 6

7 The Rehabilitation Team / Specialists Each person s rehabilitation goals are different. You may work with a rehabilitation team or rehabilitation specialists who will help you set goals based on your personal preferences and abilities. Family members and caregivers also help determine needs and plans. Your rehabilitation team / specialists may include: Physician Your rehabilitation doctor s (physiatrist) objective is to restore maximum function. Your physician is also concerned with the medical management and planning of your program. Case Manager Case managers act as a link between you, your insurer or other payer, and the treatment team. They also provide you and your family with weekly progress updates, schedule meetings and educational sessions, and coordinate discharge. Rehabilitation Nurses Rehabilitation nurses assist you and your family members and/or caregivers to develop and utilize skills for self care to meet your rehabilitation goals. The nurse s primary role is to teach you wellness behaviors for self management. Coastal Rehabilitation 7

8 Occupational Therapist Your occupational therapist concentrates on daily living activities such as bathing, dressing, homemaking tasks and personal hygiene, as well as problem-solving, decision-making and energy conservation skills. Your therapist will work with you to develop your upper body strength and coordination and provide you instruction in using adaptive equipment. Physical Therapist Your physical therapist works with you to learn skills designed to build strength and endurance, improve coordination, balance, movement and/or walking. Your physical therapist concentrates on activities to improve your head and trunk control, sitting balance, motor development, joint range of motion, sensation and functional activities. Speech and Language Pathology Services Your speech language pathologist provides diagnosis and treatment of impaired swallowing, communication, thinking, memory and problem-solving. If you have hearing problems which need to be corrected so that you may participate in therapy, your speech language pathologist will consult an audiologist to provide testing for hearing devices. Consulting Rehabilitation Specialists You may require the assistance of additional rehabilitation specialists. Staff are available to assist you if you have need for social work services, psychological services, neuro-psychological services, nutritional services, respiratory services or recreational therapy. Coastal Rehabilitation 8

9 How do you know what you need? A referral for rehabilitation care may be initiated by yourself, family members, your physician, case managers or anyone involved in your care. If you wish to make a referral, please call: After receiving this initial information, our staff will review with you the initial pre-admission assessment findings and based on that assessment, the suggested scope and intensity of services the Coastal Rehabilitation Hospital staff can provide. If you agree with the suggested program of care, the staff will begin the process to schedule your participation in rehabilitation. Participation: Because insurance providers consider participation in rehabilitation an elective process, pre-certification is required by most insurers. Your case is reviewed with your insurer(s) to gain approval, determine your insurance coverage, and potential cost to you. If your insurer(s) have limits regarding particular services, our staff will work with you to determine if you are eligible for additional resources. If not, our financial counselors will assist you with establishing a payment plan. Coastal Rehabilitation 9

10 Inpatient Admission: You and/or your family will be notified when you are approved for inpatient admission and given an admission date. Plans will be made with you to make your transition to Coastal Rehabilitation Hospital. Please have a family member or caregiver accompany you on admission and bring your insurance identification card. Outpatient Admission: You will be consulted to arrange a time convenient to your schedule for your first outpatient appointment. For your first appointment, please bring your insurance identification card and assistive items you may currently use, such as a cane, walker, or any corrective device, such as hearing aids and eyeglasses. At the conclusion of your initial appointment, our staff will work with you to set up your personal therapy schedule. Referral: If, in your case, the evaluation suggests there are other more appropriate services or facilities to meet your needs, we will give you names of programs or facilities that we feel can assist you. Coastal Rehabilitation 10

11 Locator map: N ISABELLA HOLMES (THIRD ST.) BRIDGE 17 MARKET ST CAPE FEAR BRIDGE THIRD ST. WOOSTER ST. DAWSON ST. 16th ST. 17th ST. OLEANDER DR. New Hanover Regional Medical Center 76 COLLEGE RD. Coastal Rehab. Oleander Location WRIGHTSVILLE BEACH SHIPYARD BLVD. 132 Campus map: Coastal Rehabilitation Hospital New Hanover Regional Medical Center Visitor Parking Coastal Rehabilitation 11

12 Information about the facilities: Smoking: Coastal rehabilitation service buildings are smoke-free. While you are a patient at the hospital you may smoke outside in designated areas with the permission of your physician. Parking: Parking is available directly in front of the rehabilitation hospital in areas designated Coastal Rehabilitation Hospital Visitor Parking. Coastal Rehabilitation 12

13 Inpatient Admission: Therapy: You will spend time each day in the hospital s spacious 3,000- square-foot gym where you ll participate in various forms of therapies and exercises. Each of these activities is aimed at helping you to gain strength or skill to be able to do things for yourself. You will do some of these activities directly with a therapist and some of them as part of a group. Both individual and group sessions are very important. You need time to work on skills by yourself, but you can also learn different things from others in group times. Our gym is also home to Easy Street where you ll learn to maneuver in a real-world environment of streets, shops, restaurants, cars and even the beach. We also offer a smaller gym for those requiring a less stimulating environment to be able to concentrate on learning. You may also need aquatic or pool therapy to help with your movement or just for leisure. Each of the activities you learn in the Gym areas you will then practice in your room. Coastal Rehabilitation 13

14 Rooms: Most people will stay in a semi-private room receiving nursing care around-the-clock. Some individuals need to have a private room because of the care they will need. Each room has been planned so that you will have space to move around easily. Telephones Each patient has a telephone at their bedside. Television Each patient has television and cable service. Earphones are provided for your pleasure and roommate courtesy. Meals: Meals are served in the dining room, where you will eat with fellow patients. Remember we encourage independence; however, if you need assistance with the meal, staff members are available to help. With the advance purchase of a meal ticket, family members and visitors may join you for the evening meal at a minimal cost. For most individuals, breakfast will be served in their room. Some individuals will attend morning sessions to help with special eating problems. Coastal Rehabilitation 14

15 What To Bring: Clothing / Personal Belongings As part of the rehabilitation process, you are required to dress daily. There are laundry facilities for you (if you are able), your family or friends to use to wash your clothes or you may have your family or friends take your laundry elsewhere for cleaning. Please bring several days supply of clothing and personal items labeled with your name: comfortable, loose-fitting clothes with a minimal number of buttons, zippers and hooks. Casual clothes such as jogging suits are comfortable and are suitable for exercise. comfortable shoes that fit well, provide support and are lowheeled with a nonskid sole. Patients with spinal cord injuries should bring shoes that are one size or one-half size larger than normally worn. underclothes and socks outdoor wear appropriate for the season a sweater for indoor use sleepwear personal care items such as shampoo, deodorant, makeup, toothbrush, toothpaste, denture cleaner, razor, etc. electrical devices such as shavers, hair dryers, curlers, radios, clocks, etc. must be checked and approved for safety assistive items. Bring items such as a cane, walker, or any corrective device, such as hearing aids and eyeglasses Coastal Rehabilitation 15

16 Valuables: Valuables can be secured. Please let us know if you have valuables. Medication: All medication is provided by the hospital and is administered as ordered by your physician. Please bring all prescribed medications you currently take. Your nurse will return the medication to your family member or caregiver to take home. Options Available Hair Care: Salon and barber services may be arranged for you at an additional charge. Please contact your case manager or nurse to arrange services. Worship Services/Ministers: A Chaplain is available to patients at any time, or arrangements can be made for your own clergy representative to visit you. Worship services are held Sunday afternoons. Coastal Rehabilitation 16

17 Social Visiting Hours: Visiting hours are flexible, but you will be actively involved in therapy sessions during the day. Recommendations for social visitation (when no therapy is scheduled) are: Weekdays: Weekends/Holidays: 5:00 p.m. - 8:00 p.m. 12:00 p.m. - 8:00 p.m. All visitors should check with the Reception Desk before visiting a patient. To coordinate visitation during therapy hours, talk to your case manager or nurse. Accommodations: The Hospitality House of Wilmington provides lodging in a home-like atmosphere for family and friends visiting from out of town. There is no charge for using The Hospitality House although donations are appreciated. For more information, contact your case manager. We will be happy to assist with local hotel accommodations upon request. Coastal Rehabilitation 17

18 How will you know what is going on? Before you arrive at the hospital a case manager will be assigned to you. A case manager is the person who will follow you throughout the rehabilitation process, helping you make informed decisions affecting your care, acting as a link between you, your insurance company and health care team. Your case manager will hold meetings with you and your team to regularly evaluate your progress, discharge plans, home environment, physical and educational needs. Your Rights Your case manager will also provide you with the patient bill of rights, established to be sure you are aware of your rights as a patient; and information regarding advanced directives, and answer questions regarding do not resuscitate measures or living wills. Please ask any questions you may have about this information. Coastal Rehabilitation Services participates in education and research. You may determine whether you wish to participate in research studies or receive care from a student. You have freedom of choice regarding your care or discontinuation of care. You will also be given information regarding procedures for involuntary discharge or discharge against medical advice. Coastal Rehabilitation 18

19 What can you do? Being a rehabilitation patient is not an easy process. It requires a lot of work. At times you will feel frustrated and overwhelmed; this is normal, don t be discouraged. Work as hard as you can. The amount of effort you put forth will return to you in your progress. Be assured your team and the staff of Coastal Rehabilitation Services will be there to support you every step of the way. What can my family do? Your family, significant others, caregivers and friends are part of the rehabilitation team and are expected to participate in frequent education sessions. It is necessary for people involved with your care to gain experience in such things as patient care skills, dressing programs, walking techniques, car transfers, communication and language exercises, ways to give you continued support and encouragement. Patient and family/caregiver educational sessions are held to discuss issues associated with lifestyle changes. Individual conferences may also be scheduled with social work staff. Coastal Rehabilitation 19

20 Getting Ready To Leave Once the physician and rehabilitation team determine you are ready to start your transition home, you may be scheduled to spend time in the independent living suite located in the hospital. The suite offers you a home-like setting in which you and your family members can practice skills learned in the rehabilitation process and/or you may be issued a therapeutic pass to go home or into your community to assess any special needs that may arise and to evaluate your rehabilitation skills. These passes require approval by your insurance carrier. Community Support Groups Community support group meetings are held for individuals and their families with: Stroke Brain injury Spinal injury Amputee You will be given information about the time and place of the meetings. Discharge Your team works with your case manager to recommend follow-up medical equipment and therapy services. Working with the supplier of your choice, as well as your insurer, your case manager will assist you to make decisions regarding what you need. Coastal Rehabilitation 20

21 Some people do not require inpatient services and begin their care directly in outpatient services. You may be independent enough to do so. Others may advance from inpatient to day to outpatient care. Day Program Services: You will have your own team of rehabilitation specialists working with you to learn ways to be more independent. You will spend your evenings and nights at home and work with your team during the day. You may participate in the program three or five days a week for four to six hours each day. Your individual schedule will be designed to match your goals. Day Services may be right for you if you need to fine-tune your independence skills or if you need more intense work to become more independent in your community, at school or work. Because of the types of goals you will work on in the Day Program setting you will find that much of your activity will occur in groups. You will practice your skills with community outings and group times to show you that you can do things independently in these places, with distractions, complicated physical challenges and social pressures. Coastal Rehabilitation 21

22 Outpatient Services: Disability or limitations, whether permanent or temporary, can change your everyday routine. Overcoming the effects of an illness or injury may require your participation in an outpatient rehabilitation program. Physical therapy, occupational therapy, and speech language pathology allow for hands-on, individualized programs to assist you in regaining skills and comfort in every day functional activities. The therapy staff will work with you to meet your specific needs and goals. Many diagnostic conditions may benefit from therapy treatment. Conditions commonly treated in the outpatient rehabilitation setting include, but are not limited to: amputations hip and knee replacement arthritis, bursitis, tendonitis multiple trauma back or neck pain muscle strain or joint sprain balance & vestibular disorders neurological disorders chronic pain orthopaedic conditions communication disorders pediatric conditions complications from diabetes speech abnormalities CVA/stroke spinal cord injuries developmental delays sports related injuries fractures swallowing difficulties hand injuries & carpal tunnel syndrome work related injuries headaches wound care Coastal Rehabilitation 22

23 How do I get started in an outpatient therapy program? Referrals may be made directly by physicians, individuals, health care professionals, counselors, worker s compensation providers or attorneys. In order to be eligible for third party payors/ insurance coverage of outpatient therapy services, a written physician order must be provided. Payment is accepted from insurance agencies and third party payors following registration and authorization procedures. Patient financial counselors are available to help with registration, filing of insurance, and arranging payment plans. After pre-registration is completed, you will be consulted to arrange a time convenient to your schedule for your first outpatient appointment. For your first appointment, please bring your therapy prescription, insurance identification card and assistive items you may currently use, such as a cane, walker, or any corrective device, such as hearing aids and eyeglasses. Please dress in comfortable clothing and sturdy shoes to allow your best participation in therapy. At the conclusion of your initial appointment, our staff will work with you to set up your personal therapy schedule. On your initial visit, an individualized evaluation will be performed to identify limitations that affect your ability to perform self care, mobility or daily living skills. The therapy staff will work with you to bring together your personal goals and the physician s recommendations to develop a program specific to your needs. A therapy program may include education, exercise programs, pain control, sensory and perceptual motor training, mobility skills, and return to work/sports preparation. The frequency and length of your visits will be scheduled to most effectively meet your therapy goals. Coastal Rehabilitation 23

24 What programs and services are offered in outpatient rehabilitation? The Outpatient Rehabilitation Center at 5220 Oleander Drive is equipped with sophisticated equipment and technology in addition to having highly trained and skilled clinicians. Outpatient therapy offers a variety of programs and services, including specialized programs in orthopaedic rehear, hand therapy, manual therapy, aquatic therapy, vestibular rehabilitation and sports rehabilitation. There are group-based activities for industrial rehabilitation, arthritis and diabetics aquatic exercise programs, and an After Hours program for independent exercise. Pediatric patients and patients with neurological conditions may receive outpatient services at Coastal Rehabilitation Hospital site. Please refer to the section labeled DAY HOSPITAL for more information about these programs. Your active and consistent participation in your rehabilitation program is essential for your success. Appointments are available 7:30 a.m. until 6:00 p.m. Mondays through Fridays. If you need to cancel an appointment, you are requested to give 24 hours notice. If you are late, you may be asked to reschedule for a different time or see the next available therapist. If you are consistently unable to attend your scheduled therapy appointment or have more than 14 days between visits, you may be discharged from the program. A new physician order will be required to resume therapy in the event of discharge. Coastal Rehabilitation 24

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