RESTORING. independence and quality of life

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1 RESTORING independence and quality of life MERCY CENTER FOR REHABILITATIVE MEDICINE ANNUAL REPORT FY 2015

2 Thank you for your interest in Mercy Center for Rehabilitative Medicine. Many people we serve have faced catastrophic illness or injury and we are happy to support them on their journey to maximum functional recovery. As part of the largest trauma hospital in the state of Iowa, we offer the highest level of care to our patients dealing with stroke, brain injury, spinal cord injury, burns, amputation or multiple trauma. We are accredited with the Commission for Accreditation of Rehabilitation Facilities (CARF) for comprehensive rehabilitation of persons we serve. This past year has seen many changes, we have welcomed two new physiatrists: myself and Dr. Anthony Kopp. Dr. Kopp comes to us from University of Michigan where he completed his Physical Medicine and Rehabilitation residency. His interests include Cancer Rehabilitation. I have come from Baylor College of Medicine with interest in Brain Injury Medicine. Another great asset to our team of providers, is Nancy Cambron, ARNP. In addition, we have brought many changes to the program, including: New equipment including: Bioness functional electrical stimulation, body-weight supported treadmill, and Bioness Integrated Therapy System (BITS). Expansion of Recreational Therapy services offered including group activities to promote healing through social interaction. Have seen a drastic increase in the case mix index, indicating our ability to care for very ill patients Improvements in our FIM change from admission to discharge, indicating our ability to deliver a top level of therapy and medical services to the persons we serve Numerous staff have obtained Certified Brain Injury Specialist certification. Other certifications include LVST Loud for Parkinson s Patients and Certified Rehabilitation Nursing, and specialty certification for spinal cord injury. Our staff has a wealth of experience and information to deliver the highest level of rehabilitative care for our patients and I am very proud to be a part of the Center for Rehabilitative Medicine Team. THE MISSION of Mercy Center for Rehabilitative Medicine is to maximize the potential of each person served to live at home and in the community through promotion of health, healing and wellness. AT THE CENTER FOR REHABILITATIVE MEDICINE, rehabilitation is viewed as a process of providing in a coordinated manner those services deemed appropriate to the needs of a person with physical and cognitive impairments. The program is designed to achieve objectives of improved health, welfare and the realization of one s maximum physical, social, psychological and vocational potential for useful and productive activity. The person served, and his/her support system, play a key role, receiving education and training throughout the evaluation and intense treatment process. A person-centered philosophy guides the service delivered by the center s team and is communicated to the person served and other stakeholders through individual and team interaction from pre-admission to discharge. OUR PROGRAM IS ACCREDITED by the Joint Commission and by the Commission on the Accreditation for Rehabilitation Facilities (CARF) for Comprehensive Integrated Inpatient Rehabilitation. CARF accreditation represents the highest level of endorsement that can be awarded, showing an organization s programs and services are of the highest quality, measurable and accountable. MERCY CENTER FOR REHABILITATIVE MEDICINE LEADERSHIP Respectfully, Mary E. Russell, D.O., M.S. Medical Director Mary Beth Russell, D.O. Medical Director Rachel Anderson, MSN, RN Program Director 1

3 A bad fall can t keep him down Comprehensive integrated inpatient rehabilitation Mercy Center for Rehabilitative Medicine not only strives to provide the highest quality clinical care, but also personalized treatment to help persons served manage their physical, emotional and spiritual health needs. The center is specifically tailored to meet the needs of the following types of patients: Stroke Brain injury Spinal cord injury Amputation Multiple trauma Fractured hip, pelvis, femur Bilateral knee replacement September 30, 2014, began like almost any other day for Craig Farley; he was at a friend s house helping with yard work. His friend left to run a few errands. One minute, Craig was on the roof trimming a tree branch and the next, he was lying on the deck eight feet below. He remembers telling his body to Get Up! and becoming angry when his arms and legs would Thank you to all of the doctors, nurses, therapists, and all staff from the Emergency Department through Rehab. Craig Farley Of his 19 day ordeal, Craig spent eight days in the Center for not listen; he had sustained a spinal cord injury. Craig began praying to God and became instantly calm he had no pain, yet no ability to move. Within a few minutes, a neighbor came to tell him an ambulance was on the way. The ambulance took him to Mercy Medical Center Des Moines, where Craig underwent testing to determine the extent of his injuries. Dr. Esmiralda Henderson with Mercy Neurosurgery and the Mercy Spine Program performed surgery the following day to repair damage to the vertebrae in Craig s neck. He had also broken his right forearm, Rehabilitative Medicine (CRM) at Mercy. Craig regained his balance, allowing him to stand and walk without assistance. Craig feels because of the professional, informed, and kind staff at CRM, he was well on his way to making a full and complete recovery when he left. It has been ten months since Craig s injury and he still receives outpatient therapy once a week. Craig adds, Thank you to all of the doctors, nurses, therapists, and all staff from the Emergency Department through Rehab. A big thank you to my surgeon, Dr. Esmiralda Henderson (neurosurgery) and Dr. Mary Russell (CRM). wrist, and left forearm. 2 3

4 Working with friends made the difference Family encourages the fight to never give up When Christine Williams woke up on a transferred to the Center for Rehabilitative Thursday morning, she knew something Medicine (CRM) at Mercy. Upon arrival to was off ; she felt weak and not her usual CRM, Christine was only able to flap my self. She sought medical attention, but feet like flippers and whisper. One day shy received no explanation and was sent of four weeks later, Christine was walking home. Early Sunday morning, Christine in the halls with a front-wheeled walker was unable to move her legs and was or a cane. unable to stand up from the recliner. Her Christine states she made friends with youngest son, Elijah, knew something all of her therapists, nurses, and patient was not right and suggested calling care technicians (PCTs), which made an ambulance. Christine refused, and rehabilitation feel like working with instead asked for a glass of water. When friends. Her advice to others in similar she was not able to swallow the water, situations is to be your own advocate. she and Elijah immediately suspected the worst. Elijah called an ambulance and Christine was rushed to Rehabilitation felt like Mercy Medical Center working with friends. Des Moines. Christine s Christine Williams other son, Joshua, immediately began the nine hour road trip from North Dakota. Labs were drawn and analyzed at Mercy and the Centers for Disease Control (CDC). Christine s physicians started treating her with a medication used to treat Guillain-Barre. Slowly, she started improving and was On January 11, 2015, Marva was visiting family in Iowa when she ended up in the pathway of a semi. She was hit head-on and transported via helicopter to Mercy Medical Center Des Moines. She has no memory of the accident as she suffered a traumatic brain injury (TBI). The first thing she The time spent in rehab was invaluable. The therapists and social worker are very caring and helpful. Michael and Marva remembers is waking up before her first knee from lying in bed having a difficult time surgery, able to recognize getting up with assistance to walking people around her. with a walker on her own. Marva was admitted to Mercy Center Marva was discharged home on April for Rehabilitative Medicine (CRM) on 3, She is still using a walker and January 23 to start three hours per day sometimes a wheelchair if she really of physical, occupational and speech needs it. Michael has made the house therapy. When she arrived, she had just handicap accessible. She is doing been cleared to eat solid foods but still outpatient therapy and doing very well needed assistance from her husband with her recovery. Michael and Marva and staff. Because of her brain injury, enjoy running and since Marva is not Marva had to be reminded of where she able to run right now, Michael runs and was and why she was in rehab. After her pushes Marva in her wheelchair. When third surgery, a bone marrow transplant, talking about their experience at Mercy Marva s husband, Michael, said it was CRM, they say, The time spent in rehab like a switch was flipped. Marva was was invaluable. The therapists and social clearing cognitively; she knew where she worker are very caring and helpful. They was and why she was here. She went were all encouraging to work with. 4 5

5 Small steps on the journey to recovery Mercy Center for Rehabilitative Medicine () Fiscal Year 2015 In November of 2014, Sandra Nagle began noticing decreased feeling in her lower legs. By February 2015, Sandra had no feeling from her waist down and cattle prod-like jolts going down both legs. Her husband was lifting her in and out of chairs and her bed. Despite testing, a cause was not found until April. A mass in her thoracic spine was pressing on her spinal cord, causing the weakness. Surgery was performed on May 1, 2015, and Sandra started therapy while still in acute care. When she came to the Center for Rehabilitative Medicine (CRM), staff was using a special lift to transfer Sandra and support her while showering. Slowly, Sandra improved and began using a slide board to assist with transfers. As she prepared for discharge, she is able to move independently with use of a wheelchair and still needs a little support to use a walker, although Sandra will quickly say, this is just me being nervous. PATIENT STATISTICS Admissions Patient days ,803 Average length of stay days Average occupancy rate % Number of discharges Average daily census Adjusted relative weight/ Adjusted CMI /National ADMITTING DIAGNOSIS Number of patients Percentage Stroke % Brain injury % Debility % Orthopedic % Neurological % Multiple trauma % Spinal cord injury % Amputee % REFERRAL SOURCES Number of referrals Percentage Mercy Medical Center Des Moines % Mercy Network 6 1% Other (home, skilled nursing facility or other acute hospital) 71 12% Progress was slow and steady but the improvements were worth it. GENDER Male 149 Female 107 AGE OVERALL PATIENT SATISFACTION 90% Median Health Stream Inpatient Rehab 85% 6 7

6 AVERAGE THERAPY (NUMBER OF HOURS PER DAY) Amputee 3 Brain injury 3 to 4 Orthopedic 3 Spinal Cord Injury 3 Stroke 3 to 4 Debility/Medically Complex 3 FUNCTIONAL INDEPENDENT MEASURE (FIM) GAIN FROM ADMISSION TO DISCHARGE Diagnosis National Amputee Brain injury Left stroke Multiple Trauma Right stroke PAYOR* Percentage Medicare (manage/non manage) % Blue Cross % Medicaid (managed/non managed) % Commercial insurance % Other 15 6% * Numbers may not equal 100 due to multiple payors. DISCHARGE DISPOSITION Location Total number National Community/Home % 75.8% Acute care (unplanned) % 11% Skilled nursing facility % 13.8% LENGTH OF STAY AVERAGES (DAYS) Diagnosis Amputee 13.6 Brain injury 11.9 Debility 13.5 Left stroke 15.1 Multiple Trauma 14.8 Neurological 14.5 Orthopedics 11.5 Right stroke 17.5 Spinal cord injury 16.3 PERCENTAGE OF PERSONS WHO ACHIEVED THEIR PREDICTED OUTCOMES (DISCHARGE TO COMMUNITY SETTING) BY DIAGNOSIS National Amputee 69.2% 74.5% Brain injury 56.4% 74.9% Debility 84% 78.5% Stroke 60.2% 73.8% Multiple Trauma 71.4% 79.5% Neurological 83.3% 76.8% Orthopedics 80% 80.6% Spinal Cord Injury 68.8% 75.3% 8 9

7 For more information, contact: Mercy Center for Rehabilitative Medicine th Ave., Des Moines, IA (515) REHB /15