About Us V2
Many of my patients have asked me why I Start In Home Rehab - NorthMetro Denver. The following is a letter I posted on a website that spoke to other physical therapists regarding my frustration with "the system" and was the catalyst that moved In Home Rehab - NorthMetro Denver forward.
"... Currently I am the coordinator of an outpatient clinic for a small community hospital AND I also work for a large hospital's homecare group. Working multiple levels of this continuum of care, I have noticed that many of my homecare patients have skilled physical therapy needs at their discharge and their option for continued care is outpatient based (since they are no longer homebound).
Often, the patients that get referred to us from homecare tend not to do well in our outpatient, "brick and mortar" environment. Common issues that we experience is inconsistent transportation, reduced tolerance for out of home activities, fear of leaving the home, secondary illnesses, poor home compliance to home exercise, inadequate family/social support, etc. Most frustrating for me is when I have a patient that needs skilled therapy 2-3x/wk but can only get to our clinic 1x every 2 weeks. What should I do in this case, fire the patient for non-compliance or see the patient and hope that something "sticks" and helps them? But, is 1x every other week going to be an issue with Medicare? I have spoken to senior services, transportation sources, family members, ... but for the most part, we just cannot get these patients into the clinic consistently.
These patients need help and if anything, a greater level of oversight, care and skilled services - in essence they need a primary care physical therapist (isn't this one of our APTA 2020 objectives?). Because of this, I have become more and more interested in doing outpatient rehab home visits. I have even spoken to many of our referring physicians and they agree that something needs to fill the void for patients like this. I have spoken to the homecare and outpatient rehab divisions of our community hospital and both have said it was not financially in our hospital's best interest to provide this type of service. I have also addressed the issue with my other employer - the homecare arm of a large hospital group - and while they have done this in the past, they too feel that it is less financially viable and would prefer to expend resources in homecare.
So, what can I do? I can fill the void!"