Made It Through Acute Care. Now What?

By Laurel DuPont, CEO of Northshore Rehabilitation Hospital, licensed physical therapist

My grandma lived until she was 94. Two years before we lost her, she went to the hospital with a broken hip. When she was ready for the next step in her recovery, we ran into trouble.

Her care team wanted to move her to a skilled nursing facility, but a bed wasn’t available right away, so they took her to my parent’s place.

“Mom, stop and think for a minute,” I said. “You have no medical training. You’ll be the one taking care of this freshly broken hip.”

They made the move anyway. Grandma spent a harrowing night in a recliner before moving to her clinical destination. It was a rough night. Something much worse could have happened. Thank God it didn’t.

It wasn’t mom’s or grandma’s fault. In fact, among the many lives she lived in her near century on this earth, grandma had been a candy striper. She knew health care better than some people might, but she didn’t know this – when your doctor talks with you or someone you love about recovery care, you’ve got options. I’ve learned that lesson after years as CEO Northshore Rehabilitation Hospital and a physical therapist.

As an inpatient rehabilitation hospital, we work with acute care hospitals every day to help patients find a facility that’s right for their recovery.  When they’re ready for that next step, we get them there safely.

Say you or your loved one has suffered a stroke. They’ve been through the worst of it, but they’ve lost something along the way. They can’t speak, walk or get dressed on their own or use a bathroom without help. Are they ready for our services – exercises using advanced equipment geared to bring back their independence? Or are they past that? Can they make do with outpatient help? Or are they up against something more serious than all of that, and survival is their key objective at the moment?

You don’t have to make the call on your own. Your health care team is there to help. And so are we. As part of a strong partnership of Hospitals and medical services across both the Northshore and Southshore regions, Northshore Rehab allows the physicians and other health care providers to share records, imaging and other pieces of the patient’s health care journey to allow for increased communication leading to improved handoff and care.

Our clinical liaisons all hold a degree in allied health and are experts who visit patients at acute care hospitals and evaluate and help guide patients and their families toward better informed choices.

To the uninitiated, the world of post-acute care can seem like a foreign country, complete with its own language. Health care folks love an acronym, but when you, a patient or concerned family member, don’t understand, the onus is on us to sweep away the mystery. With that in mind – here’s some options to consider when you’re looking at rehabilitation for yourself or someone you care about.

What types of nursing facilities can help?

Skilled Nursing Facility (SNF)

This is where they took my grandma. When you hear a health care professional refer to a “Sniff” when they’re talking about post-acute care, this is what they mean.

A SNF employs licensed nurses and other health care professionals that can help with medicine, look after wound care and monitor your patients. They also usually include forms of physical, speech and occupational therapies. The therapy a patient might get often isn’t as intense as what they’d receive in the facilities we’ll talk about later. Therapy at a SNF might be as little as 30 minutes a day – and maybe not every day.

That means for two categories of patients, a SNF might be the best choice – those who aren’t quite strong enough to endure longer, more intense versions of therapy, and those who are well enough not to need much therapy at all. Someone who just needs monitoring before they head home for good, not a lot of therapy, might benefit from a SNF. So might someone who can barely sit up from bed and needs to work their way into a more intense environment.

Inpatient Rehabilitation Hospital (IRH)

This is what we do at Northshore Rehabilitation Hospital, and I know firsthand the kinds of miracles our therapists, nurses, physicians and staff perform every day.

We’ve had patients who have arrived barely able to move or speak, who left here walking, talking and on their way back to independent living. It’s my passion – it’s a passion for all of us – and saying we believe in what it can do is an understatement.

But is it for every patient? No.

People can benefit from an inpatient rehab facility like ours when they’re ready to work. We have a gym on site with weights, robotic devices to stimulate muscles and help you walk, advanced technology that offers game-like attributes and exercises that stimulate your mind.

Our clinical liaisons and your care team can help you with deciding whether inpatient rehab is right for you or your loved one.

Long-Term Care Acute Hospital (LTACH)

You might hear your health care team refer to what sounds like “El Tack.” This is what they mean. Long-Term Care Acute Hospitals are for people who still require intensive care.

If your loved one still can’t breathe on their own, for example, but is ready to move on from a hospital’s Intensive Care Unit, often an LTACH is right for them.

That doesn’t mean no therapy happens at these facilities.

Most LTACHs offer breathing therapy – activities that help a patient become strong enough to start breathing on their own. Many offer physical and occupational therapy.

When you’re making your choice, think about what’s next in your or your loved one’s therapy – what you might hear called their “continuum of care.” What’s their next step? Often, therapy at their LTACH will make all the difference when they’re ready to move on.

How do I decide?

So many factors can play into your decision. How far is the facility from home? Can family members stay overnight? What about pets?

Two big, obvious factors you’ll consider – cost and outcomes.

Cost barriers to care can be a major stumbling block. Medicare and veterans’ benefits often offer the most help for those who qualify. From there, what’s covered decreases We work with all major insurance companies.

Something you might consider: staying in network. If the medical center where you or the person you’re helping is receiving their acute care also includes the right kind of facility for post-acute care, consider it. Often, the costs involved with staying in that network are less expensive.

Staying with the same health care organization has other benefits, too. Communication is easier – whether its sharing charts or the ease of talking among colleagues. Further, with improved communication, shared medical staff and access to records, staying within partner organizations can reduce overutilization – such as redundancy of tests – reducing overall cost.

At least as important as cost – if not more so – are outcomes. When making your decision about the next step, always check out how well the institution performs.

Most hospitals list their outcomes on their website. For example, at Northshore, we keep it right front and center here https://www.northshore-rehab.com/why-choose-us/outcomes/. I am immensely proud of our outcomes. Some key numbers to note – discharge to home, average patient stays readmission to prior hospital.

Here’s what that means – at Northshore, the vast majority – 89.3% of our patients – go home at the end of their time with us. They don’t go to a different facility. We don’t ship them back to the hospital from which they came. They go home and get back to their life.

Only 6.4% are readmitted to a hospital. This can be to address an acute issue that returned and that can be better served back at the acute hospital. Frequently, these patients return right back to Northshore Rehab again after the issue is addressed.

And the average stay of a patient at Northshore is 13.3 days. So in less than two weeks most of our patients go from struggling with a life-altering deficiency – an inability to care for themselves, walk, speak or sit up in bed – to being ready to go home again.

Research the outcomes. Tour the facilities. We love to offer tours. We even offer them online.

It’s a big decision, but never forget this – it’s yours to make.

We’re here to help.