Rehab shortage for trauma survivors strains state hospitals - WMC Action News 5 - Memphis, Tennessee

Rehab shortage for trauma survivors strains state hospitals

NASHVILLE, Tenn. (AP) - The state's trauma hospitals are straining to care for patients with brain and spinal cord injuries who are well enough to move to rehabilitation centers but can't find one that will take them.

Medical advances mean more people are surviving spinal cord and brain injuries that would have been fatal just a few years ago.

Such patients need inpatient physical and mental therapy to live independently with their injury, and some will require lifelong nursing home care.

But the demand for rehabilitation centers is outstripping the supply in Tennessee. When patients can't move to a rehab program, they must remain in the hospital.

That runs up costly bills and leaves trauma centers full to capacity, medical experts said. "If you are trying to get into Vanderbilt and the hospital is completely full, you may not be able to get in here," said Dr. John A. Morris Jr., director of Vanderbilt University Medical Center's division of trauma and surgical critical care. "If we could solve this problem, we estimate that we would save 3,000 to 4,000 bed days each year."

 Some nursing homes aren't equipped to handle the complex needs and costs of these patients, according to Katherine Moffat, spokesman for the Tennessee Health Care Association.

The hardest to place and costliest to care for are patients who need ventilators to breathe or have brain injuries because they need extra precautions and staffing, Moffat said.

Chase McDaniel, a 19-year-old from Lebanon paralyzed from the neck down after a car accident, has been trying to get into rehab for nearly 45 days.

He was rejected by 15 facilities in Tennessee and one in Atlanta although he doesn't use a ventilator and mainly needs physical therapy and help getting in and out of his wheelchair.

So McDaniel remains at Vanderbilt University Medical Center, where he has regained some feeling in his hand and can turn his right arm.

"If I was in rehab, there's no telling how much movement I could have back by now," said McDaniel, who has TennCare, the state's insurance program for the poor and disabled.

"I might be moving my arms, if I could work with somebody to strengthen them." There is no exact count of how many Tennessee patients like McDaniel cannot find rehabilitation care and must linger in hospitals.

Craig Becker, president of the Tennessee Hospital Association, said all hospitals are affected but the state's six level one trauma centers bear the brunt.

"Probably every CEO in the state has a horror story about one or more patients that they couldn't find a (rehabilitation) bed for that ended up costing that hospital hundreds of thousands of dollars," Becker said.

"There was a fellow up at Sumner Regional (Medical Center). They called him the million-dollar man because that's how much they spent on him."

Patients with insurance may face only one extra week in the hospital before they find placement in a rehab center, Vanderbilt's Morris said. For the uninsured, the wait can stretch for months.

"We have had people who we have been unable to place and they have stayed in excess of 100 days," Morris said. The delay in placement in rehab centers affects the pocketbooks of nearly everyone, the experts said.

The costs of hospital care far outstrip the costs of rehabilitation centers. "Even if a person has insurance, it won't cover all the costs," Becker said.

"The hospital ends up covering most of those unpaid costs, but the way they do that is by raising the rates on commercial insurers, and they pass along those increases to individuals."

It's unclear how many brain and spinal cord patients in Tennessee need rehab services or long-term nursing home care.

But Moffat said most nursing home patients younger than 60 are accident victims with those kinds of injuries. In 2005, Tennessee nursing homes reported 2,814 patients under 60.

That was 1,000 people more than the 1,862 such patients in 1995, according to the state Health Department.

(Copyright 2007 by The Associated Press. All Rights Reserved.)

Powered by Frankly