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On the mend.

Rehabilitation hospitals open across Indiana to meet an increasing demand for specialized, lower-cost recovery.

Two months after the accident, Jack was still in the same hospital bed. His condition had been stabilized two days after his arrival, but since then his recovery had stagnated. The bills were growing larger and his family was beginning to worry. Eventually, Jack's insurance company suggested that he be moved to a rehabilitation hospital, which could offer more specialized care while at the same time bringing his bills under control.

This scenario is typical of what inpatient rehabilitation hospitals deal with every day. In years past, a patient like Jack would have stayed in an acute-care hospital until he was ready to go home. Today, patients across Indiana can turn to rehabilitation hospitals to complete their recovery, receiving top-flight care and often saving money in the process.

"Rehabilitation hospitals are an expanding phenomenon," says Robert Morr Jr., vice president of the Indiana Hospital Association. "A few years ago, Hook Rehabilitation in Indianapolis was one of the only rehab centers in the state, but now there are many."

According to Morr, "health-care institutions began looking at the marketplace and found that there was an unmet need for those types of services." Today, there are nearly 30 inpatient rehabilitation facilities in Indiana, and there are plans to build at least four more. Some of the facilities are freestanding hospitals, while others may be physically connected to acute-care hospitals. In either case, many are affiliated with acute-care hospitals; Hook Rehabilitation Center, for example, is affiliated with Community Hospitals of Indianapolis.

The advancement of medical technology has been a major factor boosting the need for rehabilitation care. "The constant progression of technology is allowing people to survive serious strokes, disease and accidents that would have been fatal in the past," says Jean Wavuerka of Continental Medical Services, a publicly traded company that operates Kokomo Rehabilitation Hospital and is planning facilities in Fort Wayne, Terre Haute and New Albany. People who make it through such serious medical problems in many cases require some sort of rehabilitation to return to their previous lifestyles.

How can rehab hospitals offer as good or even better care, often at lower cost? "Rehabilitation hospitals can cost less because they don't require the high-tech overhead that acute-care hospitals must have," Morr says. "In addition to this, they can offer more focused care."

The cost advantages of rehabilitation hospitals are most obvious in the long term. "For every one dollar spent on rehab, there is a long-term disability savings of $30," Wavuerka claims. These figures hold true in almost all cases, including rehabilitation of stroke patients, she says.

Americans suffer hundreds of thousands of strokes each year, and the majority of the victims survive. The surviving patients frequently need rehabilitation to return to a normal lifestyle; without it, they often spend the rest of their lives in a vegetative state.

The focused care found at rehabilitation hospitals is provided by a medical staff that is trained to deal with specific types of physical injuries. Julie Morey, director of rehabilitation services at Midwest Rehabilitation Center in Indianapolis, explains how her facility administers care. As each new patient arrives, he or she is evaluated by a team of therapists, who write up specific treatment plans and goals for the patient's therapy. Once a week the team has a conference to discuss the patient's progress, and to develop a discharge plan for the return home. The team can be comprised of up to eight people, and is led by a physiatrist, who is a physician certified in physical medicine and rehabilitation.

The Rehabilitation Hospital of Indiana--a not-for-profit joint venture between Indianapolis-based Methodist and St. Vincent hospitals--operates in much the same way as it treats the patients who fill its 80 beds. RHI, which is the largest rehab hospital in the state, opened in January.

"Since we opened there has been a waiting list to get in," says Michelle Dow of RHI. The hospital specializes in injuries to the head and spinal cord, strokes, amputations, orthopedic problems and neuromuscular diseases.

Kokomo Rehabilitation Hospital, which opened its doors in August 1991, is finding similar demand. "We have been operating between 80 percent and 90 percent of capacity," says Cindy Robinson of Kokomo Rehab. The 60-bed for-profit facility specializes in recovery from brain injuries, ventilator weaning, chronic pain management and care of patients recovering from strokes.

The rehabilitation industry in Indiana has grown dramatically during the past three years, and growth appears likely to continue in the coming years. In fact, says Robinson, "there still is a lack of rehabilitation services in many areas of the state."

Barbara Gephardt, executive director of Hook Rehabilitation Center and a board member of the National Association of Rehabilitation Facilities, foresees problems if certain areas become over-bedded while others go without adequate facilities. "Quality of care can drop in areas that become over-bedded," she warns. "This happens because the supply of human resources isn't large enough to match the demand for the staff that is needed to properly run a facility."

That demand clearly will rise in the not-too-distant future. Already, some 759 rehab beds can be found in Indiana facilities. At least four new freestanding facilities are planned, with a total of about 240 beds.

The first of the new hospitals to begin operating will be the Continental Rehabilitation Hospital of Terre Haute. Ground was broken in April for the structure, which will be jointly owned by Continental Medical Services and Regional Hospital of Terre Haute. Construction should be complete by May 1993. "Several rehabilitation needs exist in the Wabash Valley area," says Jim Pethis, CEO of the facility. "One of those needs is ventilator weaning for coal miners who have had respiratory diseases."

Southern Indiana will see the addition of two new rehab hospitals in the coming months. One will be built in New Albany by Continental, and will operate as a for-profit facility. The other will be a joint venture between Clark Memorial Hospital in Jeffersonville and Frazier Rehabilitation Hospital in Louisville, Ky. The not-for-profit facility will be located next to the hospital in Jeffersonville.

The fourth new rehabilitation facility in the works will be built in the Fort Wayne area. Lutheran Hospital and Continental will be partners in the venture.
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Title Annotation:establishment of rehabilitation hospitals in Indiana
Author:Jones, Clay
Publication:Indiana Business Magazine
Date:Nov 1, 1992
Previous Article:Higher tech, lower costs.
Next Article:Let your life speak; teaching ethics in business.

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