Mount Sinai Rehabilitation Center Outcomes. Mount Sinai Rehabilitation Center 2014 Outcomes

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1 Mount Sinai Rehabilitation Center 2014 Outcomes Mount Sinai Rehabilitation Center 2014 Outcomes

2 TABLE OF CONTENTS A Message from the Chair... 3 About Our Programs. 4-5 Inpatient Rehabilitation Outpatient Rehabilitation.. 13 Specialty Program Scorecards Spinal Cord System of Care Brain Injury Specialty Program Stroke Specialty Program Amputation Specialty Program

3 A MESSAGE FROM THE CHAIR Department of Rehabilitation Medicine Kristjan T. Ragnarsson, MD Lucy G. Moses Professor Chair of the Department of Rehabilitation Medicine Icahn School of Medicine at Mount Sinai At The Mount Sinai Rehabilitation Center, my colleagues and I are committed to assisting individuals with disabilities and painful conditions. Our rehabilitation goals are to raise the level of each individual's skills and independence, educate our patients and their families about their conditions, and provide the care and support that will enable them to improve the quality of their lives. We offer our services as individual clinicians and as a team of professionals, working collegially with our patients and their families at every point in the continuum of care, providing acute care, inpatient and outpatient rehabilitation, and follow-up in the community for as long as services are needed. The Rehabilitation Center is dedicated to improving clinical care and the patient experience for the people we serve. To this end, we measure our performance and continuously look for opportunities for program development. We are pleased to report our various accomplishments in this 2014 Outcomes Report. Mount Sinai Rehabilitation Center 2014 Outcomes 3

4 ABOUT US For more than 100 years, the Mount Sinai Rehabilitation Center has repeatedly distinguished itself through excellent service to people in need. This commitment to excellence has resulted in the consistent ranking of the Mount Sinai Rehabilitation Center among the top rehabilitation facilities in the nation by U.S. News & World Report, as well as CARF accreditation of our programs Ranking #14 in Rehabilitation CARF Accreditation 16 programs encompassing Inpatient and Outpatient Rehabilitation Adult and Adolescent Designated Traumatic Brain Injury Model System of Care 4 National Recognition for Excellence in Nursing from the American Nurses Credentialing Center s (ANCC) Magnet Recognition Program

5 OUR PROGAMS Specialty Programs Comprehensive Integrated Inpatient Rehabilitation Program Spinal Cord System of Care Brain Injury Stroke Amputation Services Offered Acute Care Services Physical Therapy Inpatient Rehabilitation Occupational Therapy Outpatient Therapies Speech Language Pathology Community Reintegration Neuropsychology/Psychology Do-It! and Life Challenge Program for individuals with Spinal Cord Injuries Phase II cognitive day program for individuals with Brain Injuries Peer Mentorship and Support Groups Research Opportunities Therapeutic Recreation Vocational Rehabilitation Social Work Seating and Positioning Functional Electric Stimulation Lymphedema Management Robotics Program Mount Sinai Rehabilitation Center 2014 Outcomes 5

6 INPATIENT REHAB 904 Patients In 2014, our patients came from 16 different states within the US and 2 foreign countries Population Mix 50% 50% 6

7 WHO WE SERVE Age Groups Payer Mix Source: Uniform Data System CY 2014 Mount Sinai Rehabilitation Center 2014 Outcomes 7

8 CASE MIX INDEX (CMI) Case Mix Index (CMI) is a relative value assigned to a diagnosis-related group of patients in a medical care environment. The CMI reflects the diversity and clinical complexity of the patient population. The Mount Sinai Rehabilitation Center has experienced a rising CMI over the past five years. In 2013 and 2014, our patients were more complex, on average, than patients served in rehabilitation facilities throughout the nation. 8 Source: Uniform Data System CY 2014

9 PATIENT SUMMARY Stroke Spinal Cord Brain Injury Amputee Neuro Ortho Volume CMI Length of Stay * Spinal Cord Injury includes traumatic, non-traumatic and other spinal cord dysfunction The CMI drives the amount of resources required to care for the patients impacting length of stay (LOS). LOS varies with individual patient characteristics, diagnosis, progress and recovery. In 2014, the average LOS at Mount Sinai was 18.5 days. Patients are offered over 3 hours of therapy at least 5 days per week. Mount Sinai Rehabilitation Center 2014 Outcomes 9

10 FUNCTIONAL GAIN FIM Change The Functional Independence Measure (FIM ) is the gold standard for measuring function in the rehabilitation industry. The FIM provides a uniform system of measurement for disability, indicating how much assistance is required for an individual to carry out activities of daily living. Over the years, consistent with the increasing complexity of patients, the FIM score upon admission and discharge are slightly decreasing, In 2014, the improvement in function, as measured by the FIM tool, is 23.5 points. We have seen tremendous improvements in my husband s abilities to walk and care for himself since he has been in their care. - Press Ganey, August

11 DISCHARGE DESTINATION The goal of inpatient rehabilitation is to improve function in order to be discharged home. Almost 70% of our patients are discharged back to the community following their stay. A percentage of patients transition to sub-acute settings (SNF) to continue their rehabilitation. This allows for extended time if modifications are needed in the home or additional supports needs to be put in place. There is also a small percentage of patients that require a return to the acute hospital setting due to changes in medical status. As part of the greater Mount Sinai Hospital, transitions of care are seamless. Rehabilitation does not stop at the point of discharge from inpatient rehab. We follow up with our patients 90 days after discharge to assess their function, satisfaction and recovery. In 2014, 92% of our patients were back living in the community. Source: Uniform Data System CY 2014 Mount Sinai Rehabilitation Center 2014 Outcomes 11

12 PATIENT EXPERIENCE Press Ganey At Mount Sinai, the patient experience is a priority. In 2014, the Rehab Center exceeded the national average in categories spanning Rehabilitation Doctor, Physical and Occupational Therapy, Discharge Planning and Personal Issues (pain control, attentiveness). We ranked in the 74th percentile for overall patient satisfaction in comparison to other rehabilitation facilities across the nation. As patient experience continues to emerge as an important focus in healthcare, we are finding ways to tailor our care to each patients needs. The entire staff reflected care, concern, education, & training. - Press Ganey, February Source: Press Ganey CY 2014 Discharges

13 OUTPATIENT REHAB Volume and Growth Services Provided Source: Mount Sinai Hospital Internal Dashboard Mount Sinai Rehabilitation Center 2014 Outcomes 13

14 SPINAL CORD SYSTEM OF CARE 2014 Complete Tetraplegia Incomplete Tetraplegia Paraplegia Other SCI Dysfunction Volume Average Age 38 y.o. 59 y.o. 54 y.o. 68 y.o. LOS (days) We are skilled in ventilator management and cared for 4 vent-dependent patients in Robotics Program The Bionics Research Program at Mount Sinai has provided more than 530 walking sessions with 37 research participants through

15 PROGRAM SCORECARD 94% of patients are satisfied with the Spinal Cord System of Care Over 61% of our patients meet their goals during their they stay at The Mount Sinai Rehabilitation Center. Discharge Destination Sources: Uniform Data System, MedTel CY 2014 Mount Sinai Rehabilitation Center 2014 Outcomes 15

16 BRAIN INJURY SPECIALTY Patients Served: 153 Average Age: 59 years 2014 The Mount Sinai Rehabilitation Center is a designated Model System of Care by the National Institute on Disability and Rehabilitation Research (NIDRR). Our Brain Injury research funding exceeds $2.5 million through federal and state support. FIM CHANGE GOAL ATTAINMENT Over 55% of our patients meet their goals during their they stay at The Mount Sinai Rehabilitation Center. On average, patients stay with us for 19.9 days. 16

17 PROGRAM SCORECARD 98% of patients are satisfied with the Brain Injury Specialty Program Discharge Destination Sources: Uniform Data System, MedTel CY 2014 Mount Sinai Rehabilitation Center 2014 Outcomes 17

18 STROKE SPECIALTY 2014 Patients Served: 217 Average Age: 65 years The Mount Sinai Stroke Center has received Joint Commission certification as a Comprehensive Stroke Center, making it the first stroke center in New York State to receive this distinction. FIM CHANGE GOAL ATTAINMENT Over 50% of our patients meet their goals during their they stay at The Mount Sinai Rehabilitation Center. On average, patients stay with us for 19.7 days. 18

19 PROGRAM SCORECARD 98% of patients are satisfied with the Stroke Specialty Program Discharge Destination Sources: Uniform Data System, MedTel CY 2014 Mount Sinai Rehabilitation Center 2014 Outcomes 19

20 AMPUTATION SPECIALTY 2014 Patients Served: 21 Average Age: 67 years Prosthetic Use* 92% of patients discharged from our Center have been fitted for a prosthesis. 75% are using the prosthesis for walking. FIM CHANGE GOAL ATTAINMENT Over 65% of our patients meet their goals during their they stay at The Mount Sinai Rehabilitation Center. On average, patients stay with us for 15 days. 20

21 PROGRAM SCORECARD 88% of patients are satisfied with the Amputation Specialty Program Discharge Destination Sources: Uniform Data System, MedTel CY 2014; Prosthetic use data is CY Mount Sinai Rehabilitation Center 2014 Outcomes 21

22 The Mount Sinai Hospital Mount Sinai Rehabilitation Center 1 Gustave Levy Place New York, NY Inpatient Admissions Outpatient Rehabilitation Find us at: 22

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