Inpatient Acute Rehabilitation

Program Scope

Acute rehabilitation is a short term intensive program for patients aged 16 and over who have good potential to return to home or another community setting. Patients admitted must be medically stable but still need close supervision from a physician to safely engage in rehabilitation. Active participation in three hours of therapy per day is required, so patients must have appropriate endurance, the ability to learn, and be likely to experience significant practical benefit from therapy. The patient must also be able to participate without significant risk of harming themselves or others. Psychiatric diagnoses, if present, must be stable. The program will work to accommodate requests related to cultural needs whenever these can be met in a manner that maintains respect and safety for others in the environment.

Typical diagnoses include stroke, spinal cord injury, amputation, major trauma, brain injury and neurological disorders. Some patients who have had a joint replaced due to arthritis or who have a fractured hip as well as a complicating medical condition may also be eligible. Kaweah Health Rehabilitation Hospital offers specialty care in both amputation and stroke. The amputation specialty program admits patients with above and below knee amputations on one or both legs. The stroke specialty program admits patients with strokes caused by clots or by bleeding that result in significant loss of mobility, swallowing or speech.

Program Description

Patients receive individualized attention from an interdisciplinary team, led by a physician experienced in physical medicine and rehabilitation. Rehabilitation nurses provide specialized nursing care 24 hours a day, 7 days a week. Physical and occupational therapists work closely with each patient to develop a treatment plan designed to meet the patient’s specific goals. Speech therapy is available as needed. Therapies are provided 3 hours per day, 6 days per week. An activities coordinator will work with each patient to assist with returning to life roles and leisure interests. Case management professionals provide emotional support and assistance in coordinating plans to return home. Patients and their families are informed throughout their stay of any coverage limitations imposed by their insurance company and alternative sources of funding and programs are discussed as needed. Other services, including respiratory therapy, registered dietician, chaplain visits and pharmacy are provided as needed. Services may also be provided by referral, including services such as prosthetic and orthotic fitting, durable medical equipment, and specialty consultations. Referrals are accepted from case managers, physicians and family members. The program accepts Medicare, Medi-Cal and commercial payer sources.

Strategic Plan

The rehabilitation program regularly reviews areas of strength and weakness in the program, as well as identifying areas for further growth. The result is a strategic plan that the leadership team discusses every quarter to ensure that progress is being made on our identified goals and priorities.

For the coming year, some of the key areas for focus are:

Improve Kaweah Health Rehabilitation Website for better user experience including functionality and content.
Implement stakeholder input for ease of providing feedback while on site.
Improve accessibility for patients to services provided.
Improve census and stability and maintain financial strength.
Interviewing patients during their stay to determine if there are concerns that could be addressed in order to improve the patient experience.

Program Outcomes

In 2022:

Patient Satisfaction

Overall recommendations: 74%, benchmark 69^th percentile and national benchmark 68^th percentile (NRC survey started on 7/1/22).
Internal data with follow-up phone calls: (117 patients interviewed during 7/1/22-12/31/22)
- 98% would recommend inpatient rehab
- 94% felt prepared for discharge.

Results Calendar Year 2022 (CY2022)

87% of patients returned home, better than the national average of 83%
Our average length of stay is 12.7, better than the national average of 13.3 days
64 % of the patients on discharge met or exceeded expected goals, that national average was 69%
The program has served 492 patients for the CY2022, up from 449 patients in CY 2021

Stroke

89% of the patients returned home (better than the national average of 79%)
Our average length of stay is 14 days (better than the national average of 15 days)
69% of the patients on discharge met or exceeded expected goals (better than the national average of 66%)
The program served 140 stroke patients for the CY2022

Orthopedic

88% of the patients returned home (better than the national average of 86%)
Our average length of stay was 11.2 days (better than the national average at 11.9 days)
61% of patients on discharge met or exceeded goals (the national average at 71%)
The program served 112 patients for CY2022, an increase from 77 patients in CY2021

Cardiac

85% of the patients returned home (better than the national average of 84%)
Our average length of stay was 10.6 days (better than the national average of 10.7 days)
58% of our patients met or exceeded discharge goals (the national average at 72%)
The program served 27 patients in CY2022, up from 21 patients in CY2021

Amputee

82% of the patients returned home (the national average at 83%)
Our length of stay was 11 days (better than the national average of 13 days)
77% of the patients on discharge met or exceeded expected goals (better than the national average of 68%)
The program served 51 patients in CY2022, up from 46 patients in CY2021

Spinal Cord

87% of the patients returned home (better than the national average of 80%)
Our length of stay was 17 days (the national average of 17 days)
68% of the patients on discharge met or exceeded expected goals (better than the national average of 64%)
The program served 31 patients for CY2022, up from 26 patients in CY2021

Questions or feedback? Please call: 559-624-3700