HealthSouth Rehabilitation Hospital of Altamonte Springs Focusing on personalized, accelerated care to give patients back their independence
As a nationwide leader in rehabilitation services, Encompass Health Corporation, formerly HealthSouth Corporation, has been known in the medical community for over three decades and operates 120 hospitals around the nation. In 2015, the company, already present in the state of Florida, expanded to Central Florida, bringing an exemplary level of post-acute care to the region with the opening of HealthSouth Rehabilitation Hospital of Altamonte Springs. With11hospitals located in other regions of Florida it had built a solid reputation for its comprehensive approach to rehabilitation of patients, including those dealing with traumatic injuries that require extensive rehabilitation services. With the opening in Altamonte Springs, HealthSouth Altamonte Springs provided new options to the Central Florida community, options to benefit patients with acute care needs and their families committed to getting them back home, getting them back their independence and living life to its fullest.
Based on 2016 data, Encompass Health accounts for 22 percent of licensed beds in the nation and provides rehabilitation services for 29 percent of Medicare patients. The 50-bed, all private room, hospital in Altamonte Springs is often close to capacity, with the hospital seeing over 1,800 patients since it opened its doors in the fall of 2015.Now the hospital was allowed an expansion, and received a reaccreditation by the Joint Commission as a facility of care.
For Dr. Eliam Fuentes, Medical Director of HealthSouth Altamonte Springs, it was not surprising; “Since our opening we have helped so many patients providing excellent rehabilitation care for many Stroke, Parkinson’s, and other catastrophic injuries.”
Dr. Fuentes began seeing patients at HealthSouth Altamonte Spring in 2014, after doing his residency in Cleveland, Ohio. He was drawn to the endless possibilities that would result in bringing an established hospital system to a growing and aging community. “Being such a large corporation, Encompass Health has rehab down to a science, we have resources and each hospital can function and operate and focus on specialties needed in our patient population.”
“The Upswing of Medicine”
HealthSouth Altamonte Springs employs a staff of more than 100 who are quick to point out what sets their teams and their services apart. First is clearing up the misconception, that because “rehabilitation” is in the hospital name, that it is the same as a skilled nursing facility. The hospital also provides access to independent physicians specialized in rehabilitative medicine including Dr. Fuentes, Dr. Dana Kuriakose and Dr. Li Liu.
“At a skilled nursing facility a patient’s stay is a lot longer and they have approximately three to five hours of rehabilitation a week. At HealthSouth Altamonte Springs, we are a hospital and as such we are regulated to do 15 hours of therapy each week,” explains Dr. Kuriakose.
Because of the intensity and scope of services, the average patient stay at HealthSouth Altamonte Springs is just 10-14 days. The therapy is intentional, focused, multi-disciplinary and effective. For 2017, the company had a 79.4 percent discharge rate back to the community outperforming the Uniform Data System for Medical Rehabilitation average of 75.9 percent.
“The biggest thing to educate our patients about is that they’re not going to spend all day in bed. The goal here is to be out of bed, in the gym and working toward independence. For some, that is terrifying and for some, that is a welcome change,” says Dr. Kuriakose. “We almost take a second seat as a physician, because the real goal is to get their therapies and ultimately transition them home.”
The HealthSouth Patient
Most HealthSouth Altamonte Springs patients are admitted from local acute care hospitals, although some are referred from home or other long-term care facilities. Patients admitted to HealthSouth Altamonte Springs face complex situations resulting from stroke, spinal cord injuries, amputations, traumatic brain injuries, ALS and neurologic cases. The hospital is also one of the few facilities in Central Florida certified in LSVT programs designed for Parkinson’s disease. In addition, the hospital current holds disease-specific care certification for its stroke rehabilitation program.
For all patients though, regardless of their injury, there is a common denominator. Patients and their families must be committed and able to handle the intense rehabilitation they will undergo at HealthSouth Altamonte Springs.
“If you have a complex patient with many medical comorbidities, it is a challenge to do therapies outpatient or at home,” explains Dr. Fuentes. “Most patients cannot endure home therapies and some think they can’t tolerate three hours of therapy, but many can and they do.”
Before a patient is admitted, he or she undergoes pre-admission screening. Nurses do a CMS guideline screening, patients are then evaluated by a physiatrist and physical and occupational therapists.
“Every patient is exposed to multiple therapies. Patients engage in physical therapy and we see how they perform. If they can tolerate it, it’s a good predictor of their success in an inpatient rehabilitation facility,” says Dr. Fuentes.
Planning Discharge at Admitting
For HealthSouth Altamonte Springs patients, discharge planning begins at admission.
“We work as a team. From day one, we establish realistic goals that involve patients, family, and the whole team. The whole idea is to set up a rehabilitation plan that includes the patient, and an interdisciplinary team aimed to guarantee a safe discharge home,” says Dr. Fuentes.
This includes case managers planning ahead for everything from durable medical equipment to dialysis treatments, so that when patients can return home they have everything that they need to sustain their rehabilitation success.
For patients, being part of an acute care facility means that they will move around and benefit from it. HealthSouth Altamonte Springs prides itself on extremely low infection rates, half the benchmark for national rehabilitation hospitals.
“This is exceptional, especially considering we are working with post-surgical patients,” says Dr. Fuentes. “It is not only about function. As physiatrists, we are trained in wound care, and our hospital is blessed to have a great wound care program that handles complex wounds on a regular basis.”
The “Team Conference”
At HealthSouth Altamonte Springs, the multi-disciplinary team is charged with executing a roadmap that will get patients out of their hospital bed and home. The hospital has all the specialties of an acute hospital including infectious disease, cardiology, gastroenterology, internal medicine, neurology, neuropsychology, psychology, wound care, nephrology and in-house dialysis.
These specialists, comprising the team, meet two to three days per week in what is called the “team conference”. Working cohesively as a group in these “team conferences” they ensure that patients are getting all of the services they need to get them home faster, healthy and infection free.
At the table, you will find the entire team including the physician, a pharmacist, physical therapist, occupational therapist, speech therapist, registered dietitian, nurse and a case manager. The first team conference takes place within the first week of admission after the patient has fully been assessed. Together the 15-20 members of the team come up with one solidified idea to make a patient more functional with the ultimate goal is to start addressing a patient’s needs early on.
“These meetings help us to coordinate patients’ needs better,” says Dr. Fuentes. “Every portion is so valuable and will help the patient turn the corner.”
Physiatrists – the Quality of Life Specialists
Physiatry is a specialty that began during wartime, caring for the military during the first and second World Wars. The physiatrists at HealthSouth Altamonte Springs point out that while not as well known in the United States as in other countries, it is a specialty that is growing exponentially.
“As a specialty, physical medicine & rehabilitation focuses on function. We treat neurological, and musculoskeletal conditions and that limits independence” says Dr. Fuentes.
For those who have made their careers in physiatry, such as Drs. Fuentes, Kuriakose and Liu, it is a specialty of the heart. Each has a unique path that led them to this field.
Dr. Fuentes did his residency at Case Western Reserve University at the MetroHealth Rehabilitation Institute of Ohio, where spent part of his residency at the trauma hospital and at the Veterans’ Hospital in Cleveland treating traumatic brain injuries and spinal cord injuries. For him, overseeing a patient’s rehabilitation from a devastating injury and observing their strength, and the strength of their families recommitted him to the specialty.
Dr. Fuentes understands firsthand the life-changing effects of rehabilitation. At the age of two his daughter suffered a stroke and became a patient at the HealthSouth hospital in Puerto Rico.
“I changed my career goals after that. Other specialties don’t have the ability to see the direct results of treating complex issues. My daughter was completely dependent when she became a patient at HealthSouth Puerto Rico. And now, here we are years later, she is a normal 12-year-old and has recovered completely. I often share this story with my patients. It helps us create a rapport. I don’t presume to know whatever the patient is feeling, but I’ve been there in a hospital, crying and I have been in their shoes.”
For Dr. Kuriakose the specialty is incredibly rewarding because she can oversee a patient’s progress. “We get to see patients over a long period of time, their progression and as they move back into the community.”
It was while in residency at Harvard that she treated Boston Marathon bombing victims and witnessed firsthand the strong sense of support within the rehab community.
“This support is invaluable for patients. I consider it a privilege to be a part of the team that gives them the physical and emotional tools to regain their independence.”
At HealthSouth Altamonte Springs, the physiatrists and therapy teams work in tandem, providing an acute rehabilitation facility that offers patients the ability to be monitored and have their therapy directed from all angles. This aids in overall positive outcomes and patients return to an independent, albeit perhaps new normal, life.
The gym, located in the center of the hospital, is a focal point of a patient’s time at the facility and boasts the most advanced equipment. Patients can move easily from one modality to the next during their multiple visits to the gym each day. Modalities include partial weight bearing equipment, to gate training, to IREX, a new modality that is a virtual reality therapy system which uses immersive video gesture control.
For Dr. Fuentes and his colleagues time spent at the inpatient rehabilitation hospital is a critical component to a patient making important strides in his or her recovery.
“I would advise them to trust our care and providers. We have the best therapy teams, we have the best nursing teams and we have an excellent team of doctors dedicated to our patients.”
HealthSouth Altamonte Springs has plans to eventually expand beyond its 50 rooms, to meet the growing needs of the Central Florida community. For its current and future patients, and the Central Florida medical community, Dr. Liu hopes they will embrace the incredible value of acute rehabilitation.
“It’s the upswing of medicine,” he says. “With the work we are doing here, we can make it so patients don’t have problems later on. Very very small things can make big differences later on – think of it as the butterfly effect with medicine.”
With the commitment of its staff, therapists and physicians, HealthSouth Altamonte Springs continues to spread its wings, and reach those with acute rehabilitation needs, providing patients with a road to recovery in order to return home, to a new normal and regain a level of independence despite their injuries.