Pioneering Miracles. Program

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3 Pioneering Miracles Established in 1982, The Transitional Learning Center (TLC) at Galveston, Texas, is a pioneer in the field of brain injury treatment. TLC provides survivors of brain injury with the special rehabilitation and medical services needed to achieve the highest degree of function possible and sometimes miracles. TLC s not-for-profit mission is three-fold, encompassing treatment, research, and education in the field of post-acute brain injury rehabilitation. With locations in Galveston and Lubbock, Texas, both facilities offer patients the opportunity to engage in real life activities thru the community. TLC Galveston is located in the heart of a charming, historic neighborhood, complete with beautiful Victorian homes and palm trees, yet only a short walk to the University of Texas Medical Branch hospital and clinics and the delights of the beach. TLC Lubbock is located in the heart of Lubbock s medical district only a short distance from Covenant Lakeside Hospital and University Medical Center and a short distance from Texas Tech University and beautiful Maxey Park. Program TLC s program provides a full continuum of care. Our inpatient program offers the opportunity for complex, more medically involved patients to transition from comprehensive rehabilitation to community reentry and vocational programming as their functioning improves. On-site apartments provide patients the ability to practice independent living strategies in a safe environment. For patients living close to the campus, TLC offers an integrated day program and single service out-patient* treatment. Clients at TLC enjoy a natural setting for their recovery. Most clients live on-site, which allows the treatment team to observe behaviors and abilities first-hand, 24 hours a day. For patients who are no longer able to live independently, TLC offers a long-term living program (TideWay on Art work produced by a TLC client. The sentiment reads: The storm is over, let the rainbow shine through. Galveston Island) and respite services for caregivers of Pick up the pieces as only you can do. individuals with brain injuries. For more information on Open your heart and peacefully accept the new. As life goes on so will you. TideWay please see the insert in the back jacket of this brochure or visit TideWay on the web at *Galveston only Treatment No two brain injuries are alike and each patient has unique needs. After a thorough evaluation, an Individualized Program Plan (IPP) is written for each patient, incorporating only those therapies the individual needs to meet their personal treatment goals. The plans ensure that patients are provided care appropriate for their abilities, yet intensive enough to reach their goals in as short a period of time as possible. TLC offers patients an integrated approach to therapy. Each patient is assigned a case manager who serves as the advocate for the patient and liaison with families, referral and funding sources. Each patient is assigned a specific team of therapists as well, so that patient needs are fully addressed with all therapists working together to achieve the best possible outcome for the patient.

4 Case Management Because survivors of acquired brain injury often have multiple and complex treatment needs, rehabilitation is beyond the scope of any one therapeutic discipline. For rehabilitation to be effective and bring about functional change, a coordinated effort from all disciplines involved is necessary. Service coordination, effective and timely communication, and appropriate utilization of financial and rehabilitation resources are all necessary to bring about desired rehabilitation outcomes. This is the primary task of TLC s Case Management Department. Each client is given a specific treatment team of highly qualified professionals and a case manager. The case manager coordinates treatment and discharge with the client,treatment team,funding source and family. Each patient is assigned a Case Manager with years of experience in post-acute rehabilitation. The Case Manager is responsible for orienting the patient and family to the post-acute rehabilitation process. The Case Manager provides education and support to the patient and his/her family, acts as the patient s advocate with external service providers, and is the primary contact person with the patient s funding source to ensure funding and rehabilitation resources are used appropriately. The Case Manager is also actively involved in discharge planning. Education Students and interns come to TLC to learn from all over the country. These internship programs provide guided clinical supervision in which health care specialists work side-by side with TLC staff. Teaching programs help assure a dynamic environment through the exchange of ideas and the application of state-of-the-art equipment and methodology. This challenges our staff to stay current in their fields, supplies additional treatment capabilities to the program and provides TLC with a steady stream of qualified staff from which to select new staff members. TLC provides thousands of hours of training to residents, interns and fellows each year. Students have come to us from the University of Texas Medical Branch, San Jacinto Jr. College, Washington University, Texas Tech University, Texas State University, Tennessee State University and the University of Texas to name just a few. Staff TLC is a not-for-profit facility which provides the opportunity to be less profit driven and more focused on the quality of our staff and the care they provide. We do not routinely use contract staff. The professional staff are TLC employees. They specialize solely in brain injury treatment and have a thorough understanding of the program. They work in concert with other members of the treatment team for improved consistency and coordination of Our goal is to have a program in which we would feel comfortable having our loved ones reside. Brent Masel, M.D., Administrator and Medical Director services. TLC s staff is recognized both nationally and internationally as experts in the field of brain injury treatment and are licensed or certified in their fields of expertise. Many staff members hold Masters or Ph.D. degrees in their fields. TLC Galveston s Administrator and Medical Director is a board certified neurologist. In Lubbock, the medical director is board certified in physical medicine and neuro-rehabilitation. The facility also provides comprehensive nursing care for those patients needing medical attention. This level of staffing is unparalleled in the field of post-acute brain injury treatment.

5 Physical Therapy (PT) The PT staff at TLC is committed to assisting our patients achieve their mobility goals. After an in-depth evaluation, an individual therapy plan is developed to address each patient s specific needs. Our highly trained, skilled, and dynamic team of licensed Physical Therapists and Physical Therapy Assistants offer a full spectrum of intensive therapies to each patient. These services include: therapeutic exercise regimens spasticity management programs wheelchair seating clinics and mobility training forced-use (neurodevelopmental) techniques intensive gait and transfer training programs balance remediation techniques cardiovascular endurance programs aquatic therapy (pools and services available at both TLC and TideWay) Physical Therapists at TLC use everyday objects and state-of-the-art equipment to help clients achieve their mobility goals. Our physical therapists work closely with the Medical Director and other disciplines in helping to facilitate: serial casting in conjunction with Botox regimens Baclofen pump therapies splinting orthotics and other equipment needs The PT staff is part of a well-integrated interdisciplinary team that places the needs of the patients first and foremost. Occupational Therapy (OT) Occupational therapy at TLC helps individuals with brain injury achieve independence, wellness and prevention in all facets of their lives. Survivors of brain injury often have to re-learn simple tasks, such as basic self care, transportation skills, or money management. Occupational therapy assists patients in reconstructing their lives after brain injury and developing the skills for the job of living necessary to lead independent and satisfying lives. The OT staff provides functional self care evaluations and treatments in the areas of: personal management meal planning and meal preparation mobility money management upper extremity/hand function functional perceptual-cognitive skills adaptive equipment and upper extremity splinting Clients at TLC utilize community resources to practice their skills for the job of living. Therapists accompany them to recommendations and usage training provide guidance and structure and to evaluate their success. guidance to family members and caregivers customized cognitive rehabilitation using re-training and compensatory strategies home assessments for accessibility, accommodation and safety

6 Speech/Language Pathology (SLP) Utilizing individual and small group sessions, the SLP staff at TLC focuses on community re-integration, allowing therapists to assess the patient s functional communication skills in a variety of real-life situations, such as in a restaurant or grocery store. The SLP department focuses on improving speech and language skills needed during activities of daily living. Reading, writing, and social skills are addressed and often focus on return to work or return to school goals. Co-treating with other departments utilizes a trans-disciplinary approach to problem solving and develops solutions for increased patient independence. The SLP department evaluates and treats: cognitive linguistic skills language speech voice augmentative and alternative communication swallowing (VitalStim Certified) Therapists at TLC are skilled in augmentative and alternative communications. Therapeutic Recreation (TR) The Therapeutic Recreation staff at TLC works with patients to achieve a healthy leisure lifestyle using safe, productive ways to spend their time. Patients are assisted with structuring their leisure time in order to maintain or improve their current quality of life. New activities are learned and old activities are re-evaluated to determine the need for assistance and/or adaptive equipment. Patients are seen in a community setting on a weekly basis, where their money management skills, social interactions, initiation and functional ability to travel safely in the community can be assessed in the context of leisure activity. The TR staff works closely, often co-treating, with all the clinical departments in implementing strategies developed from Physical Therapy, Occupational Therapy, Speech and Language Pathology and Neuropsychology in order to facilitate the best outcomes for patients at TLC. The staff of the TR department extend the pursuit of formal therapy goals into the weekend and evening hours allowing the patients to carry out formal strategies in a more unstructured setting. The Therapeutic Recreation program allows clients to practice all of their new skills in a community setting. Outings incorporate mobility, psycholsocial, and cognitive skills.

7 Neuropsychology (NP) When individuals sustain a brain injury, they experience a variety of cognitive and emotional difficulties. TLC considers neuropsychological assessment crucial to the precise targeting of treatment focus. Every patient admitted receives a comprehensive neuropsychological evaluation that assesses intellectual, cognitive, and emotional strengths and weaknesses. Based on the needs of each individual patient, the NP department provides: cognitive rehabilitation therapy individual and group psychotherapy for depression, anxiety, and other psychological consequences of brain injury group treatment focused on stress management, disability adjustment, orientation, and cognitive skills Individual and small, focused group sessions allow for specialized cognitive and behavioral interventions. treatment for behavioral issues (e.g. impulsivity, socially inappropriate comments, substance abuse, physical and verbal aggression) Rehabilitation is a challenging process that requires a high level of motivation and effort on the part of the patient. Individuals with brain injury experience challenges due to pain, fatigue, frustration tolerance, and a host of other factors. The neuropsychology staff work closely with other departments to optimize patients participation in therapies and thus their benefit from their entire rehabilitation program. Vocational Services When a return to work or school I the focus of rehabilitation, TLC has a long history of helping patients achieve these goals. TLC coordinates services with the Texas Department of Assistive and Rehabilitative Services (DARS) and community educational providers and focuses therapy toward achieving vocational outcomes. vocational assessments job seeking and retention skills training job readiness training community-based job trials job placement Research Brain injury research at TLC in Galveston is a cornerstone of the program. Innovative, groundbreaking studies, such as the use of hormone deficiency and replacement advance the treatment of brain injury. Results are clinically integrated into the programs and individual s treatment when appropriate. In this way, TLC patients have the opportunity to benefit from state-of-the-art scientific knowledge. A full listing of our current projects and research partners can be found on our web site at

8 Outcomes TLC strives to constantly improve its clinical service delivery system using objective and subjective data sources for this purpose. Upon admission, baseline information is gathered from each clinical discipline for each patient. Disciplines use specific measures relevant to the services they offer, and the functional level of the patient. For example, Occupational and Physical therapy use the FIM (Functional Independence Measure) and the SF-36 Health Survey among others. Additional outcome measures (Disability Rating Scale, Supervision Rating Scale, etc.) are administered on the day of admission. Just prior to discharge, these same measures are re-administered to objectively gauge a patient s progress. At discharge, patients and their family members are encouraged to complete a satisfaction survey. TLC uses state of the art assessment tools to track progress and assess program effectiveness. After discharge, at one, six and 12-month time points, patients receive follow-up contact and general measures of outcome are re-administered to determine if progress made during rehabilitation is maintained over time. TLC publishes program evaluation and consumer satisfaction data in a formal report each quarter, and at the end of each fiscal year. Specialized reports for referral and funding sources can be developed on request. For the latest outcome information visit us at and click Research/Outcome Research on the navigation bar. Admissions Information The Admission Department at TLC is highly skilled at obtaining funding for rehabilitation at the facility. TLC works with private health insurance, workers compensation plans, disability insurance plans, the Texas Department of Assistive and Rehabilitative Services (DARS), Medicare*, legal settlements, Texas Crime Victims Fund and private pay arrangements. The staff works closely with the patient, family, referral source(s) and funding source during the referral and admission process. They can answer any questions you might have about our program and services. *Galveston only

9 Why Choose TLC? Nationally recognized pioneer in the field of post-acute brain injury treatment since Not-for-profit status allows us to be less focused on profits and more focused on patient care and staff qualifications. Full array of treatment modalities including a physician and comprehensive nursing care. Patients receive a minimum of 6 hours of therapy each day from licensed/certified therapists. This intensity of care means patients return home as quickly as possible with better outcomes. Innovative, clinically integrated research in post-acute brain injury rehabilitation. Accredited by the Commission for the Accreditation of Rehabilitation Facilities (CARF) and certified by *Medicare as a CORF (Certified Outpatient Rehabilitation Facility). Bilingual therapists provide services to Spanish-speaking patients and families. Family friendly with visiting hours from 8am to 8pm, 7 days a week and video phones for families to talk to and see their loved ones while in the care of TLC. *Galveston only TLC and TideWay clients and their families stay in touch and close the distance with facility provided video phones. For more in-depth and detailed information about TLC and TideWay, please visit us on the web at or call (Se Habla Espanol) DADS #00551

10 For clients who are no longer able to live independently TLC offers long term living at TideWay on Galveston Island and for caregivers TideWay offers respite services. DADS #

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