2018 A NATIONAL PROVIDER 2018 A NATIONAL PROVIDER all … · 2018 A NATIONAL PROVIDER 2018 A...
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A NATIONAL PROVIDER A NATIONAL PROVIDER 2018 2018 outcomes for most severe traumatic rehabilitation patients FOCUSED LOOK AT SHEPHERD CENTER PATIENTS WITH THE MOST SEVERE TRAUMATIC INJURIES Severity of rehabilitation patients is categorized by CMS into case-mix groups [CMGs]. DISCHARGE Signi�icantly more patients with the highest severity discharge to home after rehabilitation at Shepherd Center. *† 85.8% 58.4% Most Severe Traumatic Brain Injury [CMG 0207] >27.4 ABSOLUTE PERCENTAGE CHANGE 62.2% >24.9 ABSOLUTE PERCENTAGE CHANGE Most Severe Traumatic Spinal Cord Injury [CMG 0405] 87.1% TRANSFER TO ACUTE CARE Shepherd Center is prepared when patients require intensive medical management. Our team of experts – including physiatrists, internal medicine/pulmonology intensivists and specialized clinicians – collaboratively manage the most medically complex, traumatic patient care needs. Daily, they work to minimize conditions that result in setbacks and/or loss of function. This effort results in fewer patients who require transfer to an acute level of care. *† *Nation: Re�lects all UDS MR rehabilitation facilities for CY 2018. All Shepherd and nation data from UDS MR reporting for CY 2018. †Data reflects outcomes for these most severe patient groups. 0201 0202 0203 0204 0205 0206 0207 7 CMGs = TRAUMATIC BRAIN INJURY Fifty-eight percent of Shepherd Center’s patients with traumatic brain injury are in the most severe group, CMG 0207. 0401 0402 0403 0404 0405 5 CMGs = TRAUMATIC SPINAL CORD INJURY Thirty-six percent of Shepherd Center’s patients with traumatic spinal cord injury are in the most severe group, CMG 0405. all about us COMPREHENSIVE CONTINUUM OF CARE Patients at Shepherd Center get more than comprehensive medical and rehabilitation care: They get an experience that brings healing and hope through our specialized, comprehensive services. Uninterrupted and customized care across the continuum optimizes patient outcomes after discharge. BOARD-CERTIFIED PHYSICIANS Shepherd Center’s team of 20 highly specialized, experienced physicians are dedicated to helping patients rebuild their lives. Access to a higher level of expertise results in better care outcomes for those we serve. INPATIENTS SERVED [CY 2018] Shepherd Center has grown to a world-renowned, 152-bed hospital that treats more than 900 inpatients each year. Patients travel from across the nation and world to Shepherd Center for its innovative brand of neurorehabilitation. INPATIENT DISCHARGES 934 PATIENT DAYS: 46,719 BRAIN INJURY Includes: - 135 Stroke - 35 Disorders of Consciousness 417 f s f s f s s DUAL 71 NEURO PARALYZING 30 OTHER Includes multiple trauma and orthopedics 20 SKIN 95 - C - - SPINAL CORD INJURY Includes: - 3 Amputation 301 ICU Services: Patients who are hemodynamically unstable and/or require advanced medical management of their ventilators are admitted to our 10-bed Intensive Care Unit. Once their condition is stabilized, they move into their speci�ic rehabilitation program, avoiding costly and unsettling transfers to an acute care facility. SERVING PATIENTS ACROSS THE NATION Shepherd Center has treated more than 15,000 inpatients from all 50 U.S. states and more than 50 foreign countries and territories (since 1996). OUTPATIENT PROGRAMS & SERVICES More than 7,900 individual patients bene�ited from Shepherd Center’s outpatient programs and services in CY 2018. Transition Support Services High-risk patients stay healthy at home and lower their risk of readmission to the hospital through the support of our professional team of nurses, case managers, life skills coaches and vocational counselors. Outpatient Rehabilitation and Day Program Specialty Services Progressive therapy programs enable patients to continue their recovery and advance functional gains to perform the skil ls necessary for community reintegration. Medical Clinics Comprehensive care programs at Shepherd Center treat the array of secondary conditions of patients who have experienced spinal cord injury, brain injury, multiple sclerosis and other neurological conditions. NUMBER OF PATIENTS >1,100 100 – 250 15 – 99 5 – 14 <5 None One Stop Care: Multiple Levels and Unique Services INTENSIVE CARE MEDICAL/ SURGICAL INPATIENT REHABILITATION OP AND DAY THERAPY PROGRAMS MEDICAL CLINICS LIFE SKILLS AND VOC COUNSELING RECREATIONAL WELLNESS TRANSITION SUPPORT PROGRAM Referrals from U.S. Trauma Centers INPATIENT OUTPATIENT ONGOING WELLNESS PM&R.................................... 70% Neurology ........................ 20% Internal Medicine ...... 10% 80% * SECONDARY Specialties PRIMARY Board Certi�ications Brain Injury......................... 6 Spinal Cord Injury ....... 4 Pain Medicine ................. 2 Pulmonology.................... 2 Internal Medicine ....... Neurology ......................... Neuroimaging ............... Neurotology.................... 1 1 1 1 Patient Outcomes for Most Severe Traumatic Spinal Cord Injury and Traumatic Brain Injury • Shepherd • UDS Nation of IRFs Applies to All Graphics 3.9% 18.1% 3.5% 13.2% 20% 15% 10% 5% 0% 3.9% 3.5% 13.2% Traumatic Brain Injury [CMG 0207] Traumatic Spinal Cord Injury [CMG 0405] ADMISSIONS BY STATE: 2016-2018 1,856 ICU Patient Days 220 Direct ICU Admits 374 Encounters Treated in ICU
Transcript of 2018 A NATIONAL PROVIDER 2018 A NATIONAL PROVIDER all … · 2018 A NATIONAL PROVIDER 2018 A...
A NATIONAL PROVIDER A NATIONAL PROVIDER2018
2018
outcomes for most severetraumatic rehabilitation patients
FOCUSED LOOK AT SHEPHERD CENTER PATIENTS WITH THE MOSTSEVERE TRAUMATIC INJURIESSeverity of rehabilitation patients is categorized by CMS into case-mix groups [CMGs].
DISCHARGESigni�icantly more patients with the highest severity discharge to home after rehabilitation at Shepherd Center.*†
85.8% 58.4%
Most Severe Traumatic Brain Injury[CMG 0207]
>27.4ABSOLUTE
PERCENTAGECHANGE
62.2%
>24.9ABSOLUTE
PERCENTAGECHANGE
Most Severe Traumatic Spinal Cord Injury[CMG 0405]
87.1%
TRANSFER TO ACUTE CAREShepherd Center is prepared when patients require intensive medical management. Our team of experts – including physiatrists, internal medicine/pulmonology intensivists and specialized clinicians – collaboratively manage the most medically complex, traumatic patient care needs. Daily, they work to minimize conditions thatresult in setbacks and/or loss of function. This effort results infewer patients who require transfer to an acute level of care.*†
*Nation: Re�lects all UDS MR rehabilitation facilities for CY 2018. All Shepherd and nation data from UDS MR reporting for CY 2018. †Data reflects outcomes for these most severe patient groups.
0201 0202 0203 0204 0205 0206 02077 CMGs =
TRAUMATIC BRAIN INJURY
Fifty-eight percent of Shepherd Center’s patients with traumatic brain injury are in the most severe group, CMG 0207.
0401 0402 0403 0404 04055 CMGs =
TRAUMATIC SPINAL CORD INJURY
Thirty-six percent of Shepherd Center’s patients with traumatic spinal cord injury are in the most severe group, CMG 0405.
all about usCOMPREHENSIVE CONTINUUM OF CAREPatients at Shepherd Center get more than comprehensive medical and rehabilitation care: They get an experience that brings healingand hope through our specialized, comprehensive services. Uninterrupted and customized care across the continuum optimizes patientoutcomes after discharge.
BOARD-CERTIFIED PHYSICIANSShepherd Center’s team of 20 highly specialized, experienced physicians are dedicated to helping patients rebuild their lives. Access to a higher level of expertise results in better careoutcomes for those we serve.
INPATIENTS SERVED [CY 2018]Shepherd Center has grown to a world-renowned, 152-bed hospital that treats more than 900 inpatients each year. Patients travel from across the nation and world to Shepherd Center for its innovative brand of neurorehabilitation.
INPATIENT DISCHARGES 934PATIENT DAYS: 46,719
BRAIN INJURY Includes: - 135 Stroke - 35 Disorders of Consciousness
417f
sf
sf
sf
sf
DUAL71
NEUROPARALYZING
30OTHERIncludesmultiple
trauma andorthopedics
20SKIN
95-C
--
SPINAL CORDINJURY
Includes: - 3 Amputation
301
ICU Services: Patients who are hemodynamically unstable and/or require advanced medical management of their ventilators are admitted to our 10-bed Intensive Care Unit. Once their condition is stabilized, they move into their speci�ic rehabilitation program, avoiding costly and unsettling transfers to an acute care facility.
SERVING PATIENTS ACROSS THE NATIONShepherd Center has treated more than 15,000 inpatients from all50 U.S. states and more than 50 foreign countries and territories (since 1996).
OUTPATIENT PROGRAMS& SERVICESMore than 7,900 individual patients bene�ited from Shepherd Center’s outpatient programs and services in CY 2018.
Transition Support ServicesHigh-risk patients stay healthy at home and lower their risk of readmission to the hospital through the support of our professional teamof nurses, case managers, life skills coachesand vocational counselors.
Outpatient Rehabilitation andDay Program Specialty ServicesProgressive therapy programs enable patientsto continue their recovery and advancefunctional gains to perform the skillsnecessary for community reintegration.
Medical ClinicsComprehensive care programs at Shepherd Center treat the array of secondary conditions of patients who have experienced spinal cord injury, brain injury, multiple sclerosis and other neurological conditions.
NUMBER OF PATIENTS>1,100 100 – 25015 – 995 – 14<5None
One Stop Care: Multiple Levels and Unique Services
INTENSIVECARE
MEDICAL/SURGICAL
INPATIENT REHABILITATION
OP ANDDAY THERAPYPROGRAMS
MEDICALCLINICS
LIFE SKILLSAND VOC
COUNSELING
RECREATIONALWELLNESS
TRANSITIONSUPPORT
PROGRAM
Referrals from U.S. Trauma Centers
INPATIENT OUTPATIENT ONGOING WELLNESS
PM&R.................................... 70%Neurology........................ 20%Internal Medicine ......10%
80%*
SECONDARY SpecialtiesPRIMARY Board Certi�ications
Brain Injury......................... 6Spinal Cord Injury ....... 4Pain Medicine ................. 2Pulmonology.................... 2
Internal Medicine .......
Neurology.........................
Neuroimaging ...............
Neurotology....................
1111
Patient Outcomes for Most Severe Traumatic Spinal Cord Injury and Traumatic Brain Injury
• Shepherd • UDS Nation of IRFsApplies to All Graphics
3.9%
18.1%
3.5%
13.2%
20%
15%
10%
5%
0%
3.9%3.5%
13.2%
TraumaticBrain Injury[CMG 0207]
TraumaticSpinal Cord Injury
[CMG 0405]
ADMISSIONS BY STATE: 2016-2018
1,856 ICU Patient Days220 Direct
ICU Admits 374 EncountersTreated in ICU
A NATIONAL PROVIDER A NATIONAL PROVIDER2018
2018
Shepherd 31% 29% 08% 32%
UDS Nation of IRFs 01% 04% 02% 93%
RIC 04Traumatic
Spinal Cord Injury
RIC 02Traumatic
Brain Injury
RIC 18Major Multiple
Trauma with Brain/Spinal Cord Injury
All OtherNon-Traumatic
RICs
outcomes for all patientsShepherd Center’s comprehensive healthcare expertise enables the hospital to treat medicallycomplex situations and deliver the highest quality of patient outcomes. Favorable outcomes ensurea level of health and rehabilitation readiness to optimize each patient’s results.
COMPLEXITYPatients with catastrophic injury have a higher severity of illness, requiring complex medical management at Shepherd Center.*
SAFETYShepherd Center is “better than the nation” in four quality-of-care measures.*
READMISSIONA customized “Transition Support Program” successfully reduces 30-day hospital readmission rates at Shepherd Center.*
VENTILATOR WEANINGShepherd Center achieves highly favorableventilator- weaning rates across all injury types.*
outcomes for all acuities oftraumatic rehabilitation patients
TRAUMATIC VOLUMEVolume matters. Expertise in caring for people with catastrophic injuries leads to superior patient outcomes.
SEVERITYThe traumatic injury and stroke patient population at Shepherd Center is more severe than the national average, with 20 to 33 percent higher case-mix indices.**
SOI 2 16.8%
SOI 3 48.8%
0% 10% 20% 30% 40% 50% 60%
2.5%SOI 1
SEVERITY OF ILLNESS (SOI) DISTRIBUTION // LEVEL 4: HIGHEST; LEVEL 1: LOWEST
SOI 4 31.9% As medical complexityevolves during the courseof rehabilitation, Shepherd Center ensures access tospecialized medical care.
*Severity of Illness (SOI) from 3M APR-DRG grouper. Shepherd includes all patients for CY 2018.
C. DIFF CLABSI VAPMRSABACTEREMIA
* Patient self-reported readmissions per 30-day follow-up phone calls for all patients discharged home from Shepherd Center, CY 2018.
6.2%AVG
30-DAYReadmission Rate
*Based on internal data from CY 2018.
DISCHARGE DESTINATIONMore than 89 percent of patients discharged from Shepherd Center return to the home. Only 3 percent require return to acute services, and 8 percent continue post-acute care.*
*Based on Soarian Discharge Disposition for CY 2018.
Patient Outcomes for Traumatic Spinal Cord Injury, Traumatic Brain Injury, and Stroke
At Shepherd Center, 68 percent of patients treated have traumaticinjuries, compared to only 7 percent of rehabilitation patientstreated across the nation.*
*Shepherd re�lects all rehabilitation patients submitted to UDS in CY 2018. Nation re�lects all patients in UDS MR for CY 2018.
DISCHARGEMore patients return home after undergoing rehabilitation at Shepherd Center for traumatic injuries and stroke.**
**Source: UDS MR for CY 2018. Shepherd includes patients with traumatic SCI, traumatic ABI, and stroke. Nation is the UDS MR “nation adjusted” for patients with traumatic SCI, traumatic ABI, and stroke.
89%Home
3%Acute Care
8%Other Post-Acute
1.79
1.35
33%HIGHER
CASE
– MIX
INDE
X 1.87
1.53
22%HIGHER
CASE
– MIX
INDE
X
20%HIGHER
2.26
1.88
CASE
– MIX
INDE
X
TraumaticSpinal Cord Injury
TraumaticBrain Injury
Stroke
TraumaticInjuries
68%
7%
86.7% 70.3%
16.4%POINTS HIGHER
21.8%POINTS HIGHER
69.1%90.9%
16.6%POINTS HIGHER
85% 68.4%
Traumatic Spinal CordInjuries
Traumatic Brain Injury All Stroke
• Shepherd • UDS Nation of IRFsApplies to All Graphics
Spinal Cord Injury:
C1-C2: 77%
C3: 82%
C4: 72%
C5-7: 100%
T1-T12: 100%
Spinal Cord Injuries
Stroke
88%
Brain Injury
90%
*Based on CMS LTCH Quality Reporting Program, published 2019.
BY THE NUMBERS Weaning Volume
Level of Total Vent Patients Injury Patients Weaned
Brain Injury 31 28
Stroke 8 7
C1-2 22 17
C3 11 9
C4 18 13
C5-C7 8 8
T1-12 9 9
