What Makes Us Different

PRC 2010 Patient Outcomes

685 patients in 2010

Patient Findings

In 2010, our Average Length of Stay (ALOS) was 13.4, in line with the region LOS of 13.9.
Stroke ALOS 16.6 in line with the region at 16.5
Cardiac ALOS of 10.6 compared to the region at 11.3 days
Our average patient age in 2010 was 72 years of age

PRC FIM Scores

Uniform Data System collects information on facilities’ FIM (Functional Independence Measures) scores to objectively measure improvements in patient function against regional and national measures.

PRC scored higher than the regional average for Stroke gain.
PRC scored at or above the scores of the region and nation for the majority of the Motor FIMs.
PRC’s Total Cognition FIMs were above both the regional and national scores.
PRC scored higher than both the regional and national scores for Total Cognition FIM.

What type of patients can PRC take?

The patient requires an intense level of service:

3 hours of therapy 5 days a week
24 hour rehabilitative nursing
A multi-disciplinary team
Close medical supervision by a rehabilitation physician
Medical acuity can’t be successfully managed by a less intensive setting

PRC can take patients with:

Tracheostomies
Wound VACs
NG Tubes / Peg Tubes / Tube Feedings
CPAP / BiPap (at night only) for sleep apnea
Blood Transfusions
IV Antibiotics
PICC Lines
Foley Catheter
Drains
Telemetry
Cardiac and Respiratory Care
Loss of function in two or more extremities
A loss in function in one extremity and medical instability
The presence of a central neurological condition affecting cognition, speech/language, balance or coordination
We will consider any patient with: Increased LOS, higher level of care, difficulty weaning from vent, comorbidities, complications, or an existing medical condition (hypertension, anemia, CHF, diabetes, etc)

What are some of the diagnoses for PRC?

PRC can take patients with the following (not an inclusive list):

Stroke
Spinal Cord Injury
Congenital Deformity
Amputation
Major Multiple Trauma
Hip Fracture
Brain Injury
Neurological Disorders
Critical Illness Myopathy
Active Rheumatoid Arthritis, Prosriatric Arthritis, Seronegative Arthopathies
Total Joint Arthroplasty of Hip or Knee with BMI>50, Bilateral joints, and/or 85 years or older
Systemic Vasculitis
Any functionally debilitated patient with ortho, neuro, and/or medical needs

What is the difference between PRC and a Skilled Nursing Facility (SNF)?

PRC	SNF
Patient requires 2 or more therapies	Patient requires less intense rehabilitation
Patient has capacity for functional improvement	Patient has severe cognitive disability or dementia
Patient has potential to participate in 3 hours of therapy 5 days a week	Patient will need therapy services up to 5 days a week
Patient is medically able to participate and requires medical care and rehab nursing (24 hour rehabilitation nursing available)	Patient is medically stable
Patients are seen daily by a medical doctor and a physiatrist (physician specializing in physical medicine and rehab)	Physician management available but not on site daily, physicians are typically internal med or family medicine
6 to 1 patient to nurse ratio	15 to 1 patient to nurse ratio
Average LOS (length of stay) is 13.4 days	Average LOS is much longer
A hospital stay is not required for Medicare reimbursement	A 3 day acute care hospital stay is required for Medicare reimbursement
Lab, radiology, respiratory, ED services available on site	Services usually not offered on site
24/7 Telemetry services	Service usually not offered
24/7 Cardiopulmonary services	Service usually not offered

“… for most patients undergoing post-stroke rehabilitation, more comprehensive rehabilitation and the presence of specialized physicians and rehabilitation nursing at an IRF increases the likelihood of the best outcomes.”
     - Robert L. Harvey, M.D., Medical Director Rehab Institute of Chicago, Managed Care January 2010

“If a SNF is to be used for stroke rehabilitation, we recommend seeking a facility offering the types of services provided in IRFs.”
     - Andrew Kramer, et al., Outcomes and Costs after Hip Fracture and Stroke, A Comparison of Rehabilitation Settings

“For most patients, post-stroke rehabilitation in the more costly and intensive IRFs resulted in higher functional outcomes compared with care in a SNF-based rehabilitation program.”
     - Anne Deutsch, PhD, RN, CRRN; Carl V. Granger, MD; Allen W. Heinemann, PhD, ABPP; Roger C. Fiedler, PhD; Gerben DeJong, PhD; Robert L. Kane, MD; Kenneth J. Ottenbacher, PhD, OTR; John P. Naughton, MD; Maurizio Trevisan, MD, MPH; Outcomes and Reimbursement of Inpatient Rehabilitation Facilities and Subacute Rehabilitation Programs