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>> Probably over the past five or six years,
there has been a real change in Medicare.
And a lot of those regulations have affected rehab units
so they pretty much gone out of business.
The rehab hospital here was closed
for about a year and a half.
And so there really are only-- were only two other facilities
that had in-patient acute rehabilitation,
a very much shortage of rehab beds.
Now that we've opened, there is 30 additional beds that are
in the mix, but in the mean time the practice pattern has changed
so that-- what's really happening is patients are going
to nursing homes to try to get rehabilitation.
For some patients, that's exactly appropriate
for very slow moving patients who really need
to take their time and getting rehabilitated.
That works, that's an appropriate thing to do.
But for the patients that could be going home independently
in two to three weeks,
that means they didn't have the opportunity
to get acute intense rehabilitation,
didn't have the opportunity to have three to five hours
of therapy a day, great medical management
by board certified physiatrist, that sort of thing.
And so, we're really looking at how we can position ourselves
so that people know that, you know,
there now are an additional 30 beds in the mix.
Well typically in a nursing home, you're not going
to have daily medical management and you certainly aren't going
to have medical management routinely by a physiatrist,
which is someone who specialized in rehabilitation care.
You're also aren't going to get the kind of intensity of therapy
or a 24-hour rehabilitation nursing
in an acute care rehab hospital or rehab center or rehab unit.
You have nurses who are working with a therapist on a team,
this is what we do,
who establish an interdisciplinary plan of care.
And then everything that the patient is getting
in these three hours, three to five hours of therapy a day
with the therapist is being carried over by the rehab nurses
so that the patient literally,
every moment is a teaching moment for patient
in a rehab center like ours.
So that we're constantly teaching
and reinforcing what the patient needs to know and needs to do
in practice in order to be able to go home safely.
Typically, nursing homes are going to send about 60 percent
of their patients back home and rehabilitation hospital
or center is going to return about 80 percent
of those patients home.
Right after that, the standard types of patients
that we're seeing are people who have experienced a stroke
or head injury, a spinal cord injury,
some kind of neurodegenerative disease like Parkinson's or MS,
we're looking at patients that might have had very,
very complex orthopedic conditions.
But over and above that, we're also looking now for patients
who were very effectively, in their community,
living their daily life without any problems independently
and now suddenly are having some decrease
in their ability to function.
Our goal is to get the patient back
into the life they lived before.
And it could be the life they lived before with a couple
of adjustments, maybe they're going to use a walker,
maybe they're going to have to use a wheelchair.
But if they enjoyed going to a restaurant
and that was their quality of life is, you know,
every Friday night I go out with my friends then I want them
to be able to every Friday night go out with your friends
and you may have to do it slightly differently.
But through therapy and the interventions,
we want to get a back there and we want you to be comfortable
to go back and do the things that you use to love to do.
I think what really sets one rehab apart
from another is what is the experience level of the staff?
Do you have staff that have done this before?
And do they have any specialties that they work in?
Are they experienced, and is it rehab experience?
And do they really love what they're doing?
What are the ratios between the nursing staff and patients?
What are the ratios between the therapist and the patients?
And who is the medical director?
Who is providing the overall leadership in that facility,
and is that a physician that you feel comfortable talking to?
Yes. The majority of our staff have over 20 years of experience
and almost all of them, over 90 percent,
have experience in rehabilitation.
We have certified staff
with neurodevelopmental training, NDT training.
I have staff that had specialties
in swallowing disorders and in stroke care.
It's a team that's worked on a team before
so they know how to work together.
And then we have Doctor Georgianni
who is just leading the group
and he is just the most amazing board certified physiatrist
with just lots of years of experience.
I think, first of all, is the fact that he has
so much experience and he is a board certified physiatrist,
that's a doctor of physical medicine in rehab.
But more than that, he trusts his patient care
and his interaction with the patients and the families.
No one comes here saying things by like, "Well,
I just don't know what's going on and no one has talked to me
and I can't find my doctor."
He is one of those people who sits down with the patients,
sits down with the family, shares with them the agony
of what they're going through and give some hope.
And typically, what you see is he really gets them to do things
that are even beyond what our expectations are
because they feel so good about him and they feel
like they really can do it as a result to his intervention.
We've really tried to make it easy for physicians,
for case managers, for any one who wants
to refer a patient to a rehab center.
All you have to do is call,
say that you have an appropriate patient, give us the name
where the patient is at and we'll come
out and do an evaluation.
>> I'm not one to make a prognosis or prediction early
on when I have patients.
I like to be inventive and creative
and try different things.
And I think if people are encouraged,
you can get a lot out of them.
In other words they have that energy
to do things most people do.
They just don't know that they can do it.
So I kind of set the bar a little bit high
but not impossible.
So if someone makes a little bit
of an achievement, they can make more.
So, sometimes people defeat themselves because they think,
for instance, if they had a feeding tube,
they couldn't go home.
I've sent tons of people home
with feeding tubes even tracheostomy tube.
They're not in a ventilator
but they have a tube for-- help them breathing.
And if you can show people that they're capable
of doing something, then generally they'll rise
to the occasion and be able to do it.
So I don't know I've-- I had to say, I've a number of cases
that have been able to go home
that they thought they will going to be maybe
in a nursing home or never get home.
People who have returned back to work 'cause one
of the things I do with them, depending on age,
now I'd say younger, is to work with them and trying to get back
into a work environment.
Sometimes that's you got to work with the employer and you got
to ask for some concessions, you know, they need some extra help.
I've gotten people back driving
that thought they what other doctors have told them they
wouldn't drive again.
But it's a very detailed process on how I assess them,
not anybody, they got to pass some test and they got to do it.
But I never, I never put down any type of notion.
I'll give-- I'll give almost anything to try within reason.
But I encourage people to travel again, to be active,
to have much of a meaningful life as they can.
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