Inpatient Rehabilitation – Parham Doctors’ Hospital


(upbeat music) – Hi, I’m Roger Giordano. I’m the medical director
of Henrico Doctors Hospital inpatient rehab program at
Parham Doctor’s Hospital. And I’d like to talk to
you a little bit today about inpatient rehab. Our unit, we’re in a special situation, because being based within
the hospital itself, our ability to manage a
higher level of medical acuity is somewhat unique for the Richmond area. So we’re aggressive with taking
people with medical needs and working through their rehabilitative needs at the same time. We can manage everything from TPN, to IV anticoagulation, tube feedings, trachs, any kind of oxygen or respiratory services you may need. We are very comfortable
doing that at the same time managing to get the intensive
services people need. They may range from
obviously physical therapy, mobility-based issues,
alternative means of mobility, occupational therapy,
including services that include upper extremity function, but also the cognitive components that go into performing daily tasks. Speech therapy, looking
at things such as swallow, cognitive function,
syndromes such as aphasia or language-based apraxia
or motor sequencing based syndromes of neglect, etc. We’re comfortable with most diagnoses, ranging from something
as straightforward as a non-elective orthopedic repair, such as a hip fracture repair, to complex oncologic patients, complex neurosurgical
patients, subdural evacuations, tumor removals, etc., etc. Cology patients that are in a gap in their chemotherapeutic regimen, to just general surgical patients and medically-complex
patients who have had a long and arduous course of acute care stay, usually ICU stay, that has made it necessary
for them to receive services prior to being able
to return home independently. There are criterion under
CMS that we need to meet. Those criterion are not
quite as hard and fast as we tend to quote, as
the liaisons are obligated to report to the patient and
to the referring centers. We do have a three hour rule
that’s part of CMS criterion, meaning a combination of
therapy services need to equal fifteen hours per week. Ideally, that’s done over five days, although we do offer therapy
services seven days a week. We do well with cognitive impairment. One of our primary
criterion for not being able to accept a patient is an advanced, long-term progressive cognitive
disorder, i.e. dementia. We will service mild to moderate dementias and we will service someone
with a more significant dementia if their goal is to return home with familial assistance. So in addition to the services we offer to the patient themselves,
we’re also able to offer family teaching as one of our services. Once again our primary goal being to return the patient to the community. In conclusion, we have shown
a dramatic level of growth over the last three years. We have gone from an average
daily census in single digits to an average daily census
in the upper twenties. We still do have room for growth. We’ve recently remodeled our unit. We have a large propensity
of private rooms now, which is much better for
patient satisfaction. But we do have the capacity
to take up to 36 patients. We are very aggressive as I’ve already delineated with providing
adequate medical care. Our nurses have become
progressively better versed in handling the medically acute patient, while at the same time
providing traditional rehabilitative nursing services. Indeed, these people
are amazing individuals, because they’re dealing with at least floor-level medical
acuity while working on constant mobilization,
assessment of those criterion that help them go home, such
as bowel and bladder, etc. If it crosses your mind that
you think they may benefit from services, let us know
and let us know early. But we’re here to help
you move your patients through to the appropriate level of care as quickly as possible to help facilitate getting them back into the community as quickly as possible. (upbeat music)

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