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Thread: Rehabilitation Center?

  1. #1

    Rehabilitation Center?

    My husband is newly injured (6-19-08), and is currently in an acute care hospital in Tucson, AZ. He is currently ventilator dependent, and the facility here (Cornerstone Hospital) has not been able to wean him off the vent. His insurance is a Medicare HMO administered by Secure Horizons (United Healthcare), and they want to send him to a SNF in Phoenix. I want him to go to a SCI rehabilitation center for weaning and acute rehab, and am looking at Shepherd Center in Atlanta or Casa Colinas in CA. Does anyone have any thoughts? If I am unsuccessful with the insurance fight, he does qualify for VA benefits, with the possibility of a VA SCI center in Long Beach, Tampa, or Albuquerque. All of this will depend on whether the facility has space and will take him, but I will be very grateful for any and all input.

    Thank you all.
    dsb

  2. #2
    Senior Member Mona~on~wheels's Avatar
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    Welcome to CC. I'm sorry to hear about your husband's sci.
    I can't help you about where to go, but there's alot of smart members on here that can.
    I hope he gets the best care possibly.

  3. #3
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    Welcome to CC. One of the nurses will undoubtedly write back to you when she can, but you are absolutely right that he should be in a SCI rehab center. Shepard Center has a very good reputation, and one of the nurses here actually works for a VA hospital in California, so she can tell you more about that. Good luck, and I'm sorry to hear of your husbands injury, but you will find out a ton of information from this site.

  4. #4
    Sorry for you and your husband to have to go through something as life changing as you are now. Another great rehab facility would be the Craig Center in Denver.
    If I was meant to have wheels under my ass, what the hell are these legs for?
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  5. #5
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    Darlene

    I'm sorry to meet you under these circumstances. I live in Phoenix, my son was injured Feb 9,2007. He was transported to St. Josephs Hospital in Phoenix. While he was in the intensive care unit at St. Josephs I started looking at rehab facilities. You can look at my thread in the NEW SCI forum, it's named RECENT ACCIDENT TO MY SON. Please take a look at my son's thread because there is information there that might be helpful.

    We considered Craig and Shepherd Center. We selected the Shepherd Center because the people at the Shepherd Center were more helpful than the contacts at Craig.

    My son was at the Shepherd Center from 3-1-07 until 7-15-07. When we left Phoenix my son had difficultly breathing but he was not on a vent. He had treatments at St. Josephs to clear his lungs where the nurse inserted a tube down his throat to make him cough. Occasionally he had sleep with a machine to force air into his lungs. Both of these things were very uncomfortable for him. At the Shepherd Center they told me that they specialize in improving the patients breathing. My son does not have breathing problems now.

    Transportation to Atlanta from Tuscon will be major hurdle. Eventually Blue Shield paid for the air ambulance flight but it took a great letter from our caseworker at Shepherd Center. The advice that I received on Carecure was very helpful. Post your questions on Carecure you'll get great responses from the members. I'm on Carecure many times each day looking for information and asking questions.

    Roger

  6. #6
    What is his actual level of spinal cord injury? Do they say he should be weanable? Have other acute care hospitals been considered such as the University Medical Center or moving him to Barrow's in Phoenix? Generally, unless the person is elderly or had pre-existing pulmonary problems, people with injuries at C4 or below should be weanable from the vent, but many health care professionals don't know the correct was to do this in SCI (which is much different than weaning AB patients). The clinical practice guidelines on Respiratory Management in SCI are a good resource and you can download these and print them out for his current team. You can find a link to them from here: www.scicpg.org

    If you can get him into a private sector, out of state rehab program (and you will have to fight HARD to get "Insecure Horizons" to pay for this) I would recommend either Craig or Shephard equally. Casa Colina does not specialize in either high level injuries or vents. If he came to CA, then Rancho Los Amigos (Downey) or Santa Clara Valley (San Jose) would be best as they both specialize in this . If he is on Secure Horizons I must assume he is older since he is on Medicare, is that correct? He is unlikely to get more than 3-4 weeks of inpatient rehab paid for under that circumstance, which is another reason to really seriously pursue his VA eligiblity.

    Have you been in touch with the SCI Coordinator (social worker) at the Tucson VAMC? If he can be weaned from the vent, he can go to any of the 22 VA SCI Centers for his rehab, but the one designated for care for those in Tucson is San Diego, and they currently don't have a vent program. Tampa is unlikely to take him as they have their hands full with Iraq/Afganistan active duty patients since they are a poly-trauma center. The same applies ot Palo Alto. Long Beach has a long established and excellent vent program, but you may not need that if he is weanable.

    Don't let him to to a nursing home. It will be a death sentence for a vent dependent new injury SCI patient.

    Have you talked to anyone from the PVA? They can help him get into the appropriate VA SCI Center, but that is also the job of the SCI Coordinator at the Tucson VA. Call them tomorrow and insist on getting the help he is entitled to.

    (KLD)

  7. #7
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    Welcome to Carecure...

    My hubby was insured by Pacificare (the non-medicare arm of Secure Horizons) all owned by UHC. And we had to fight, fight, fight to get him into Craig... but... they finally did approve the rehab... KLD is correct... More than a month in rehab will be rare... but be prepared to really go to bat for him!

    Good luck and please come back and let us know...

    Sieg

  8. #8

    Welcome:Darlene, Glad you made i t

    Glad you made it to the boards, Listen to SCI nurse, she has excellent advice. Follow up with Michael (NSO)after you meet the folks at Tucson tomorrow
    Best,
    B~
    Every day I wake up is a good one

  9. #9
    His fracture is C5, but the surgeon found bone spurs and fragments and fused C3 to C6. He was at UMC Trauma ICU until July 9 when they transferred him to Cornerstone. The UMC case manager said he needed to go to an acute care hospital then to rehab. The thinking was that he could first be weaned off the vent, then sent to local rehab (Health South). He is 59 years old (60 this November), but is on Social Security disability (hence Medicare) due to anxiety issues after quadruple bypass surgery in 1998. He has been diagnosed with moderate arterial stenosis while at Cornerstone. I am to meet with two people from the Tucson VA tomorrow as they evaluate Kevin, so am hopeful they can get him to the best place. I've been given to understand that I should fight as much as I can stand with insurance, but if we loose on appeal, we can go to VA assuming they have availability.

    I'd like California best because of closeness, but want to go to the best place we can get him to for the best results. I will look at Santa Clara Valley - I misunderstood about Casa Colina and thought they did have a SCI speciality.

    Thank you so much for this great information. I appreciate it more than I can say. I'm going to read the clinical guidelines re SCI right now.

    Bless you,
    Darlene

  10. #10
    Quote Originally Posted by SCI-Nurse
    What is his actual level of spinal cord injury? Do they say he should be weanable? Have other acute care hospitals been considered such as the University Medical Center or moving him to Barrow's in Phoenix? Generally, unless the person is elderly or had pre-existing pulmonary problems, people with injuries at C4 or below should be weanable from the vent, but many health care professionals don't know the correct was to do this in SCI (which is much different than weaning AB patients). The clinical practice guidelines on Respiratory Management in SCI are a good resource and you can download these and print them out for his current team. You can find a link to them from here: www.scicpg.org

    If you can get him into a private sector, out of state rehab program (and you will have to fight HARD to get "Insecure Horizons" to pay for this) I would recommend either Craig or Shephard equally. Casa Colina does not specialize in either high level injuries or vents. If he came to CA, then Rancho Los Amigos (Downey) or Santa Clara Valley (San Jose) would be best as they both specialize in this . If he is on Secure Horizons I must assume he is older since he is on Medicare, is that correct? He is unlikely to get more than 3-4 weeks of inpatient rehab paid for under that circumstance, which is another reason to really seriously pursue his VA eligiblity.

    Have you been in touch with the SCI Coordinator (social worker) at the Tucson VAMC? If he can be weaned from the vent, he can go to any of the 22 VA SCI Centers for his rehab, but the one designated for care for those in Tucson is San Diego, and they currently don't have a vent program. Tampa is unlikely to take him as they have their hands full with Iraq/Afganistan active duty patients since they are a poly-trauma center. The same applies ot Palo Alto. Long Beach has a long established and excellent vent program, but you may not need that if he is weanable.

    Don't let him to to a nursing home. It will be a death sentence for a vent dependent new injury SCI patient.

    Have you talked to anyone from the PVA? They can help him get into the appropriate VA SCI Center, but that is also the job of the SCI Coordinator at the Tucson VA. Call them tomorrow and insist on getting the help he is entitled to.

    (KLD)
    His fracture is C5, but the surgeon found bone spurs and fragments and fused C3 to C6. He was at UMC Trauma ICU until July 9 when they transferred him to Cornerstone. The UMC case manager said he needed to go to an acute care hospital then to rehab. The thinking was that he could first be weaned off the vent, then sent to local rehab (Health South). He is 59 years old (60 this November), but is on Social Security disability (hence Medicare) due to anxiety issues after quadruple bypass surgery in 1998. He has been diagnosed with moderate arterial stenosis while at Cornerstone. I am to meet with two people from the Tucson VA tomorrow as they evaluate Kevin, so am hopeful they can get him to the best place. I've been given to understand that I should fight as much as I can stand with insurance, but if we loose on appeal, we can go to VA assuming they have availability.

    I'd like California best because of closeness, but want to go to the best place we can get him to for the best results. I will look at Santa Clara Valley - I misunderstood about Casa Colina and thought they did have a SCI speciality.

    Thank you so much for this great information. I appreciate it more than I can say. I'm going to read the clinical guidelines re SCI right now.

    Bless you,
    Darlene

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