Mario Ruiz, who joined Community Hospital to open the IRU, and Dr. Michael Davis, the unit’s medical director

Mario Ruiz, who joined Community Hospital to open the IRU, and Dr. Michael Davis, the unit’s medical director
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Inpatient Rehabilitation Unit: 5 years, more than 1,000 patients

The first patient to come through the doors of Community Hospital’s Inpatient Rehabilitation Unit was a young man who had lost a leg to diabetes and was learning to navigate his world in his new circumstances.

In the five years since, more than 1,000 people have received the unit’s specialized care, all geared toward helping them live as independently and fully as possible after a traumatic injury, accident, or illness.

Success is measured using a standardized tool with 18 categories that gauge functional independence in everything from the ability to dress to social interaction. The staff is able to use this tool to show the progress the patient is making, which helps the patient and family get the impact of the Inpatient Rehabilitation Unit (IRU) experience.

“It gives meaning to our lives when we’re able to help people recover from devastating injuries,” says Dr. Michael Davis, the unit’s medical director. “And it’s a special moment for me, as medical director, whenever somebody says, ‘You have such a wonderful staff. They’re so caring, they’re so kind, they respond to our needs immediately.’ I hear those things over and over again.”

That can be particularly gratifying given the challenges of a stay in the IRU.

“Our unit is very demanding because of our philosophy: The more intense the rehab right after a catastrophic event, the better the success will be at the end,” says Mario Ruiz, IRU director. “On a typical day, a patient receives at least three hours of physical, occupational, and/or speech therapy, spread throughout the day, as well as work with and support from our rehabilitation nurses. It’s hard, very hard, work.”

"It gives meaning to our lives when we’re able to help people recover from devastating injuries."
— Dr. Michael Davis, Medical Director, Inpatient Rehabilitation Unit

The most common diagnosis for IRU patients is stroke, but the unit also serves patients with brain and spinal-cord injuries; amputations; neurological issues, like Parkinson’s, multiple sclerosis, or amyotrophic lateral sclerosis (commonly known as Lou Gehrig’s disease); challenging recoveries from heart or joint surgeries; and more.

A majority of patients are transferred to the unit from within the hospital, but the IRU also gets referrals from Stanford and UC San Francisco medical centers, Salinas Valley Memorial Hospital, skilled nursing facilities, and other hospitals and treatment centers.

Before Community Hospital’s center opened, people who required intensive therapy usually went to Natividad or a Bay Area facility, or they simply didn’t get the care they needed.

Now they can find the care closer to home, provided by a specially trained staff that includes a doctor specializing in physical medicine and rehabilitation, rehabilitation nurses, physical, occupational, and speech therapists, social workers, and dietitians.

“We have regular patient-care conferences, meeting as a team, which really helps me get a better understanding of the patient, the family, and the patient in the context of the family,” Davis says.

"Not everybody is going to go home, but we want to get them back to being as independent as they can be."
— Mario Ruiz, Director, Inpatient Rehabilitation Unit

The IRU emphasizes activities of daily living, such as sitting and standing, balance, dressing, grooming, bathing, improving gait, and negotiating stairs. Patients sometimes are taken on community outings to help them learn how to function in community settings.

“We also sometimes go with patients to their homes, evaluate the setting, and train family members in caregiving,” Ruiz says.

During their IRU stays, patients eat their meals in the IRU’s dining room whenever possible, which encourages social interaction that often provides peer support.

“Nobody understands what’s going on in a patient’s mind better than people who have experienced similar trauma,” Ruiz says. “Our patients often form very strong bonds with other patients.”

They also form bonds with staff. Each year, the unit has a “reunion” of its patients. The highlight of the well-attended events is a period when patients and their families share their stories, of both their challenges and their progress.

About 82 percent of IRU patients are able to return to their home, Davis says, while others go to other types of care facilities.

“Not everybody is going to go home,” Ruiz says, “but we want to get them back to being as independent as they can be.”

Admission criteria

  • At least 18 years of age
  • Medically stable
  • Requires medical monitoring and 24-hour-per-day nursing care
  • Requires at least two therapy disciplines
  • Has potential to tolerate 3 hours of therapy each day
  • Has potential to improve function or achieve independence
  • Willing and able to participate in intense therapy program

The IRU is here for those who have suffered a loss of function or an impairment due to:

  • Stroke
  • Brain injury
  • Spinal-cord injury
  • Degenerative neurological disorders such as Parkinson’s disease or multiple sclerosis
  • Amputation
  • Major multiple trauma
  • Polyarthritis or rheumatoid arthritis
  • Orthopedic injury (fractured hip or femur)
  • Other condition that has resulted in a loss of independence and mobility

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