Inpatient Rehabilitation Case Study

UNC Lenoir Healthcare Rehabilitation center is a wellness rehab located inside UNC Lenoir Healthcare on the seventh floor. We are a fully staffed in patient acute rehab center. We offer rehab services and patients on our floor receive complete and comprehensive care from a multidisciplinary team of professionals. My interview today is with a seventy seven year old, white, widowed woman. She has lived alone since 2009 when her husband passed away and her son lives nearby and checks on her daily. This client was admitted to our rehab facility on 4/4/17 with a hip and wrist fracture due to a fall in her home. I will complete an assessment of the patient and her needs to help gather the necessary information for her care plan that we will go over

I am writing to you with interest of joining your team in the position ‘New Graduate Rehab RN’. I learned of the position from a dear friend of mine who is currently a member of your team. I plan to graduate from nursing school this upcoming May and am interested in this position because I believe that it will help further my skills, education and shape me into an outstanding nurse.

The National Survey on Drug Use and Health reported in 2010 that approximately 8.88% of North Carolina residents used an illicit drug in the month prior to the survey. At the time the survey was taken the national average was 8.82%. Likewise, the rate of drug-induced deaths in the state was higher than the national average. Meanwhile, drug and alcohol rehab enrollments for cocaine addiction decreased in 2011, while marijuana addiction rehab admittances grew. Statistics from 2011 show marijuana as the leading drug of abuse among North Carolina drug rehab enrollments. This was followed by other opiates (include prescription drugs), cocaine/crack cocaine and heroin.

Spire Rehabilitation Hospital will open on July 1, 2017. Currently, the focus is on passing the state licensure survey in order to open the doors for admission on July 1. The priorities are to execute all contracts, complete policies and procedures, hire and train staff, and meet all regulatory standards in order to pass the survey scheduled for early June. Staff will target to admit 20-30 patients on July 1, and then prepare to meet Joint Commission Requirements (JCAHO) during the survey scheduled in mid-July.

Unfortunately, in recent years the cost of providing these traditional services has grown to a point that the programs set in place to care for seniors and chronically ill patients has undergone numerous cuts. This calls into question are the standards of care that nursing facilities provide being cut to compensate for these changes in the rate paid.

Susan Hartman, a Chief Executive Officer of Healthsouth Nittany Valley Rehabilitation from State College was a guest speaker of the class. Furthermore, she is also the chair of the Medical Division Committee for the Pennsylvania Association of Rehabilitation Providers and a member of the Hospital Association of Pennsylvania. Her presentation was very fascinating and highlighted the importance of Inpatient Rehabilitation and Post Acute Care in the United States. She started her presentation with the continuum of care. Gradually, she explained about the Acute care hospital and long-term acute care hospital in which the patients from both care receives an equal number of beneficial and quality care to make them better longevity. Furthermore, she also disclosed about post-acute care industry readmission rates, which showed that the skilled nursing facility has 22.0 % and inpatient rehabilitation has 9.4 % rehospitalized after using post-acute care setting. Similarly, she explained that HealthSouth overview of hospitals with IRF patients in which the average age of all patients is 72 and the age for Medicare FFS is 76. Additionally, she also talked about the operational excellence in post acute care in which everything matters for the operational excellence, including the quality, cost effectiveness and investment in

No signs or symptoms of intoxication or withdrawal are present upon admitting to the Intensive Outpatient treatment. Client reported Methamphetamine, Marijuana, and alcohol as his drug of choices. Client provided random UA on 04/16/18, 04/23/18, and 05/07/18, results were positive for Methamphetamine. Last attended treatment on 05/07/2018.

Analyzed and evaluated case notes made by Rehabilitation Counselors to determine approval or denial of services/goods provided. Researched and analyzed Department of Rehabilitation regulations to develop an office procedures manual for new employees. Communicated with clients and customers daily via telephone, in writing, and public counter regarding services provided by the department. Evaluated and reviewed supporting documents submitted for consistency, validity, and sufficiency. Contacted clients to obtain additional documents and clarification of information to determine eligibility purposes. Utilized the Department of Rehabilitation management database to input, update and retrieve client confidential information. Attended meetings and

Although most of Ms. Drinkwater’s training came from graduate school, she also received on the job training by a former employee from performance rehabilitation. Because Ms. Drinkwater is the only neurological physical therapist at her current place of employment, there is a demand for her at her job; she is the earliest person there and the last to leave. Her patients are referrals or walk-ins and the majority of her patients are short term, which run about 7-10 sessions. One-third of her patients are long-term patients each of which she has built rapport with; she has no access to patient lists, but does have access to records of the patients she treats while treating such patient.

Prior to this assignment, I had very little insight to what gatekeeping, state certificate of need programs, and Medicare PPS meant and how they affected lowering health care costs and spending. Thank you for sharing your perceptions and opinions on the regulations that’s were established within each of these laws. As a nurse who worked in a hospital, I remember having monthly educational meetings regarding length of stay, reimbursement and health care costs and spending. At that time, I felt the information seemed tedious and irrelevant to my role as a registered nurse. As a future family nurse practitioner, I can now appreciate the information and education I have gained from both my profession the assignments within this course.

Instead of providing the care they thought they would be providing, they were reigning in members to a program with the promise of improved health while they felt their own health was being neglected or jeopardized due to added stress, no time for breaks or guaranteed family time. Corporate compliance was called anonymously with complaints of working conditions and a state wide meeting was held with the RN case managers to gather information. Staff was assured that their concerns were being heard and efforts would be made to improve the current state of affairs.

Mr. Smith did well with therapy during the 1st week of rehab and was in the ultra/high window. But unfortunately he suffered from urinary tract infection at the end of second week and could participate to qualify for the ultra/high. He was short of 10 minutes at the end of second week. In this case, facility will get the reimbursement for high level. Which could be half the cost of Ultra high. In order to keep an individual for ongoing rehab, the person’s participation needs to be shown. This is shown by the number of minutes he/she participates in therapy. Sometimes, because of the acuity of illness, the person is not able to perform well, resulting in limited participation and number of minutes for therapy. When insurance sees this, they disqualify for rehabilitation. This puts an individual at risk. In order to avoid this, the organization plans to get more minutes by engaging individuals in therapy for minutes needed and to show individual compliance, despite of person’s physical capability that day.

Identify and describe an inpatient setting (e.g., acute inpatient units, inpatient rehabilitation, skilled nursing, etc.) to include the services provided, key personnel within the department, and how this department supports or is supported by other departments.

Currently, health care is experiencing many potential ethical issues regarding payment for treatment. Among the practitioners facing these issues are occupational therapists, who are struggling to figure out how to provide quality care while upholding the reimbursement guidelines. Many patients are covered by a variety of different insurance plans in the clinical practice field; payment for services is controlled by a variety of federal and private payment guidelines. This may often lead to a care level gap between patients. As the “baby-boomer” generation ages, many questions surround the healthcare industry. Different insurance plans provide certain types of health care coverage, so in some instances, differences in care may result.

The benefits of rehabilitation in an inpatient and outpatient clinic is that even though they are very different rehabilitation programs you are still able to advance on your own rehabilitation. In the inpatient rehabilitation program you are referred to physicians and therapy services while you stay in a hospital. In the inpatient rehabilitation clinic the nurses and doctors are committed to providing physical and cognitive services to the patient for as long as they stay there. The services provided in both the clinic and hospital are the same they help you make a treatment that you will be able to do and they include interactive participation and teamwork. They strive in helping you achieve your goals that you set up and they respect your