Physical Medicine and Rehabilitation

Inpatient Rehabilitation Facility

Cleveland Clinic Rehabilitation Hospital (CCRH), operating under a joint venture management agreement with Select Medical, is a system of 3 inpatient rehabilitation facilities with locations in Avon, Beachwood, and Edwin Shaw (Akron) that specializes in the medical care of clinically complex patients while providing an intensive, interdisciplinary rehabilitation program. This coordinated approach of medical care and rehabilitation enables patients to avoid rehospitalization, achieve a higher level of function, and successfully discharge to the community.

Inpatient Admissions: Case Mix Index

2017-2018

In 2018, the acuity of patients admitted to CCRH also increased. In acute rehab, case mix group (CMG) is an indication of the complexity of an individual patient and is determined by primary diagnosis, comorbidities, age, and functional assessment upon admission. A rehab hospital’s case mix index (CMI) is the cumulative measure determined by its patients’ individual CMGs. The higher the CMI, the more complex the patient population. CCRH’s overall CMI increased from 1.33 to 1.35 in 2018. This was driven by the increased acuity of patients seen across multiple diagnostic groups.

Cleveland Clinic Rehabilitation Hospital: Discharges

2017-2018

From 2017 to 2018, the number of patients discharged from CCRH increased from 1182 to 2722, with increases seen across all major diagnostic groups.

Cleveland Clinic Rehabilitation Hospital: Discharge Disposition (N =37.32)

2018

Although CCRH admitted more complex patients in 2018, discharges to acute care remained well below the acute transfer rate for SNFs in Ohio as reported by Medicare.gov.

Cleveland Clinic Rehabilitation Hospital: Change in Functional Independence

2017-2018

Under the direction of CCRH’s Physical Medicine and Rehabilitation physicians, an interdisciplinary team of registered nurses, respiratory, physical, occupational, speech, and recreation therapists, rehab aides, pharmacists, dieticians, and consulting physicians work from day of admission until day of discharge to improve patients’ functional abilities as measured by the Functional Independence Measure (FIM). FIM objectively measures the burden of care for a patient in a 24-hour period by assessing everyday activities including (but not limited to) transferring, toileting, walking, dressing, eating, and bathing. A lower FIM score indicates a lower functional level and consequently a greater burden of care. Comparing a patient’s overall FIM score at the time of admission to score at discharge quantifies the functional progress achieved. In 2018, CCRH’s FIM score for motor change from admission to discharge not only increased but also demonstrated a higher change than the recognized weighted national benchmark.

Cleveland Clinic Rehabilitation Hospital: Functional Independence at Discharge

2017-2018

Across diagnostic groups, CCRH not only admitted more complex patients in 2018 but also discharged them at a higher functional level, a level that surpassed the weighted national benchmark.

Cleveland Clinic Rehabilitation Hospital: Community Discharge Rate (N = 120.72)

2018

The Interdisciplinary Team at CCRH strives to equip all patients and their families with the resources and skills needed to successfully return to the community. In 2018, CCRH’s discharge to the community rate was well above the national average SNF discharge to community rate reported by Medicare.gov.