2010 Disclosure Statement-North Shore

This report provides information about the outcomes achieved by patients who have used the services at the Physical Medicine & Stroke Center. The information is based on an analysis of data that are collected and inputted by the facility and cumulated by several sources. The Physical Medicine & Stroke Center uses the FIM instrument to collect outcome information on patients who are admitted for inpatient rehabilitation for the first time. Erehabdata provides the program with similar information from institutions in the same geographic region and in the nation.

The FIM instrument measures functional gains of patients in a variety of different activities of daily living, and compares these gains to those made by clients in other rehab facilities in the region and the nation. The nurses and therapists base this measure on an evaluation, which is completed at the time a person is admitted to the program and again at the time of discharge.

YEARLY SUMMARY
This report gives positive news about the Physical Medicine & Stroke Center's effectiveness and outcomes during 2010. Our Center scored higher in several important measures than other inpatient rehabilitation facilities in the region and nation. We had higher percentages of patients discharged back into the community and we continuously provided “intensive therapy” at least three hours per day to our patients. The data shows we admit patients sooner after their incident than other facilities. Our patients, on average, achieved a higher level of functional gain. Our efficiency levels exceeded the national averages. Stroke is the largest category of patients that are treated, followed by debility. This information confirms the Physical Medicine & Stroke Center is providing excellent care to our patients.

Facility Participation Rates:

Ochsner Medical Center - North Shore 88 patients served
Region  31,890 patients served
Nation  178,576 patients served

Discharge
The Physical Medicine & Stroke Center discharged 78% of patients served back into a community setting as compared to 69% of those served by other facilities in the region and nation. The Physical Medicine & Stroke Center places much emphasis on our abilities to help both our patients and their families with a successful discharge to the best, the safest, and least restrictive environment. This ensures that our program meets the needs of our patients served.

Discharge Setting Ochsner-NS Nation Region
Community / Home  78.4%  67.0%  68.8%
SNF  6.8%  12.9% 16.0%
Acute  13.6%  12.5%  10.7%

Discharge to Community (home, assisted living, board and care): The Physical Medicine & Stroke Center continues to demonstrate a higher discharge back to a community setting than the region and nation.

Discharge to Skilled Nursing Facility: The Physical Medicine & Stroke Center is lower than the region and nation. We encourage family involvement from the prescreen process through the patient’s discharge.

Discharge back to Acute: The Physical Medicine & Stroke Center is slightly higher than the region and nation. Although this outcome is not ideal, we feel that it is still within an acceptable range.

INTENSIVE THERAPY PROGRAM
3 HOUR RULE: The percentage of patients that have met the Medicare requirements of receiving an intensive course of treatment while in the rehabilitation program. This is defined as 3 hours of therapy per day for at least 5 days per week. This has been met at 99.8% compliance since we offer all disciplines of therapy 7 days per week..

ONSET DAYS

The Physical Medicine & Stroke Center onset days (time from the patient’s incident/event to the admission) remains lower than region and nation. This means that we work closely with the case managers on acute to get appropriate patients identified sooner.

TYPES OF PATIENTS SERVED

IMPAIRMENT MIX: There are many types of patients who are admitted to our program. The percent of patients in each impairment group are listed below. The highest percentage of patients falls into the Stroke, Debility, and Fracture LE category. For the past four years stroke patients rank as the highest population we serve.

FUNCTIONAL IMPROVEMENT FROM ADMISSION TO DISCHARGE

The FIM instrument measures “functional gains” of patients in a variety of different activities of daily living and compares these gains to those made by clients in other rehab facilities in the region and nation.

NOTE: The total FIM score at admission estimates the severity of disability at the beginning of rehabilitation, and discharge FIM estimates the severity of disability at completion of rehabilitation. The change from admission to discharge is an estimate of rehabilitation effectiveness.

Admission FIM scores are lower than the region and nation. (Patients are also being discharged at very high functional levels almost equivalent to the region and nation). FIM scoring should be completed at the time of admission indicating the lowest score in the assessment period that is defined as the first three calendar days. This is directly linked to the accuracy of the FIM scores given by the employees that work on the unit. All rehab team members have taken the FIM exam upon hire and again during their annual competencies. Our Functional Gain/Improvement is higher than the nation.

AVERAGE LENGTH OF STAY

Patients admitted to the Physical Medicine & Stroke Center stayed an average of 14.8 days, which is a better than both the region and nation.

LENGTH OF STAY EFFICIENCY

The length of stay efficiency is the average change in functional independence measure per day of rehabilitation hospital stay. This can be defined as FIM change/length of stay. This is a crude, but useful measure of care efficiency; the higher the number, the greater the efficiency. The Physical Medicine & Stroke Center’s length of stay efficiency is 1.95, which is better than the nation and equal to the region.

  Ochsner-NS NATION  REGION
1st Quarter  2.22  1.63 1.85
2nd Quarter 1.74 1.74 1.85
3rd Quarter 2.10  2.05 2.24
4th Quarter 1.74   1.97  2.01
CY 2010 1.95  1.82  1.96