Your Guide From Admission to Discharge

YOUR GUIDE

FROM ADMISSION TO DISCHARGE

HELPING PEOPLE F I N D T H E P OW E R TO OV E R C O M E

CONTENTS

1 2 4 5 7 8 10 12 13 14

WELCOME Brief introduction

MEET YOUR CARE TEAM Everyone works toward your goals

QUALITY

SERVICE

Nutrition, housekeeping, and visitor information

H E L P F U L

T I P S

Wi-Fi, TV remote, and room telephone

DISCHARGE PLANNING The next step on your path to independence

DISCHARGE CONSIDERATIONS Medication and medical supplies

YOUR REHAB CHECKLIST A checklist for you to complete with your team

ALL ABOUT YOU Helpful information for your care team to get to know you

COMMUNITY PARTNERS Organizations to support you on your recovery journey

OUTPATIENT CARE Options for continuing care after discharge from inpatient rehabilitation

WELCOME TO

Sheltering Arms Institute Thank you for choosing Sheltering Arms Institute as your rehabilitation partner. We are here to support you on your road to recovery. This booklet will serve as an introduction to our hospital as well as a guide from admission to discharge.

You will have the opportunity to collaborate with your entire team on the goals that you expect to achieve during inpatient rehabilitation. The path to healing can be long and overwhelming after a major illness, injury, or surgery; however, we will work tirelessly to ensure that you have the training, education, and support to feel prepared for discharge.

At Sheltering Arms Institute, we are committed to your long-term recovery, including after you leave our hospital. We have community partners and agencies that are here to help you transition back to the community. Additionally, we have peer mentor programs if you would like to speak with someone who has faced a similar journey.

While here, you will benefit from at least three hours of skilled therapy Monday-Friday divided among different disciplines. Your care team will evaluate you and set realistic goals with your input.

You are the most important member of your team and we will encourage you to participate to the best of your ability.

If for some reason we do not meet your expectations, please let us know through one of the following ways: • Call the house supervisor at (804) 584-5406.

They are available 24/7.

• Ask to speak to the therapy program manager or nurse manager.

• Answer the pop-up survey on your television, which will appear every three days through the GetWell Network.

• Call the quality department directly by dialing (804) 578-6389. You may leave a confidential voicemail and will receive a response within 24 hours.

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MEET YOUR CARE TEAM C ARE MANAGEMENT

P HARM ACY SE RV I CE S

Your care manager will work with you to plan your discharge from Sheltering Arms Institute while honoring your treatment goals. They will complete an initial assessment to identify your needs, provide education on your rights and responsibilities, and review your options and insurance coverage with you.

Your care manager’s goal is to ensure a safe transition to your next level of care. If you have any questions regarding your insurance coverage and benefits, contact your care manager. Additionally, you may find price transparency information on our website.

Our pharmacists are available throughout your stay to answer any questions that you may have about medications. They are also a great resource in discharge planning to make sure that you can access the medications you need.

CH A PLA IN S E RV ICES Our chaplain offers spiritual support to patients and their families to aid in the healing process. On Sundays, we hold a non-denominational worship service in our beautiful chapel that is open to all patients. For details, call (804) 578-6577.

P HYSI CAL THE RAP Y ( P T) Your PT will work with you to develop goals to improve mobility, manage pain, and maximize function. Your therapy will vary depending on your diagnosis, however, you can expect to work to your fullest potential to maximize your recovery and gain independence at home and in the community. PT will include the use of our state-of-the-science gyms and equipment such as robotics, bodyweight support, and electrical stimulation.

P M &R P HYSI CI ANS OC C U PATIO N AL THERAPY (OT) OT promotes health and well-being through the therapeutic use of everyday life activities. Your OT will help you develop, recover, improve, and maintain the skills needed for daily life. These activities include selfcare tasks (e.g., dressing, bathing, and grooming) as well as preparing meals, taking care of children, driving, and anything else that is important to you. Adaptive equipment and a wide variety of rehab technology may also be used to maximize your recovery.

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Physical medicine & rehabilitation physicians focus on the restoration of function after neurological, musculoskeletal, or other injuries or illnesses that affect an individual’s ability to walk or perform activities of daily living. Your physician will see you daily and work closely with other members of your care team to develop and monitor your individualized care plan.

Based on each patient’s unique needs, we form a multidisciplinary team that visits patients regularly to collaborate on the creation and progress of their individualized treatment plan.

R EGIST ER E D D IETITIANS

RE SP I RATORY THE RAP Y ( RT)

Shortly after admission, you will meet with one of our registered dietitians who will assess your nutritional status and provide nutritional therapy for all types of diets. They will provide education sessions with the primary goal of improving your lifelong dietary health.

RTs help people who are experiencing breathing disorders. They perform chest exams, suggest treatments to resolve problems within the lungs, and help with breathing equipment. Not all patients will need to see a respiratory therapist.

REH ABILITATION NURSES

SP E E CH- L ANG UAG E PATHOL OG Y ( SL P )

You will benefit from 24/7 nursing care from our team of highly trained RNs, LPNs, nursing techs, patient safety attendants, and unit secretaries.

Your nursing team will assist you with medication management and will check in on you frequently to ensure your safety and well-being; they are only a call away at any time.

REH ABILITATION PSYCHOLOGISTS Our psychologists help patients and families adjust to the experience of illness or injury. They understand the complex relationships among life events, emotions, and physical health. Not all patients will need to meet with our psychologists, though sometimes it helps to talk with someone to achieve your best possible recovery. If you are not already seeing one of our psychologists and are interested in these services, please ask your physician for more details.

SLPs diagnose and treat patients with communication, cognition, and swallowing disorders, three functions vital to quality of life. These deficits may be due to a stroke, brain injury, or numerous other conditions.

Treatment may involve various rehabilitation technologies and practicing communication and cognitive skills through personally relevant daily tasks. If you are having difficulty swallowing, your SLP will evaluate your swallow and establish a plan for improving safety while eating. Not all patients will need to see a SLP.

THE RAP E UTI C RE CRE ATI ON ( T R ) TR specialists help patients reach their goals for returning to favorite leisure activities or learning new ones. They often utilize art, music, sports, and games to improve patients’ well-being. TR is a great time to socialize and meet other people throughout our hospital. Additionally, TRs serve as the connection point between you and our community partners or peer mentors as you transition back into the community.

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UNBEATABLE QUALITY SERVICE FOOD & NUTRI TI ON SE RV I CE S

You will enjoy delicious, chef-prepared meals three times daily that are customized to your nutritional needs. We will provide support for individuals who require assistance with meals and/or swallowing as well as consider your own personal dietary needs.

Our quality ingredients provide the nutritional support needed for rehabilitation progress and healing.

CAFÉ & V I SI TOR I NFORM ATI ON HOUSEKEEPING A clean hospital is important to the safety of our patients and guests. We pride ourselves on our environmental safety team (EVS) who maintain a disinfected and clean hospital.

Your room was sanitized prior to your arrival and our EVS team will help maintain cleanliness throughout your stay. Should you have any cleanliness concerns, please let your care team know immediately.

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Visitors provide social support, which aids in successful rehabilitation. The current visitor policy may be found on our website. Guests are welcome to enjoy a delicious meal in our café or on our patio where they may see family members working with therapy in our Bridge Garden.

Vending machines are located on the first floor, directly behind the front desk. Please ask a team member if you need any assistance navigating the hospital. Please keep in mind that our hospital is a tobacco-free campus.

HELPFUL INFORMATION WI-FI CONNECTION Network Name: SAI-GUEST

RO OM TELEV ISION Your television is equipped with the GetWell Network. This application allows you to view your daily schedule, care team information, medications, and educational videos that your team will customize to your needs. Additionally, you will have access to popular TV channels and a catalog of on-demand movies. A channel guide is located in your welcome bag. Should you have any questions on how to use the device, please reach out to a member of your care team.

ROOM P HON E Weekends and evenings are an excellent time to chat with family and friends who may not be able to visit you. Here’s a quick guide to the landline in your room:

Are you calling out of the hospital in the local area?

First, dial 9 to connect to an outside line, then dial the phone number.

Are you calling long distance?

First, dial 9 to connect to an outside line, then dial 1 plus the area code and phone number.

For family members who would like to call a patient’s room directly, you can find the direct number on the bottom of the television screen or ask a team member.

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CLINICAL RESEARCH Integrating research into your care plan is an important component to implement the latest advances in rehabilitation. Our clinical research committee assesses clinical trials and research studies with the goal of providing new and additional resources to our patients to improve health and function. As one of our patients, you may be invited to participate in research studies, but can always decline participation.

WEEKENDS are a time for rest and restoration.

We offer therapy seven days a week and patients should expect therapy their first weekend. On other weekends, we encourage our patients to relax and recover.

While some patients want to continue therapy on the weekends, a rest period is important to build strength and achieve your goals. Please take advantage of the activities hosted by our recreation therapists, enjoy visits from family and friends, or catch up on the latest entertainment and music offered through our GetWell Network.

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This is a common question. Your length of stay will be based on medical need and on various factors such as your diagnosis and care needs, level of function, and progress toward your goals; however, the average length of stay is 14 days. Our goal is for you to increase your independence during your inpatient stay to prepare you for the next stage in your recovery.

To do this, we offer support through a full continuum of care, including hospital rehabilitation and outpatient therapy, and by connecting you with home health and other services to help you rejoin the community. Progress continues after hospital discharge as you continue to work toward your goals.

Your estimated discharge date may change based on your progress; you may be discharged sooner than originally planned, or your stay could increase if needed.

IDENTIFYING A CAREGIVER Early in your stay, it is important to identify who will help care for you when you leave the hospital so that they can be part of your discharge plan. The level of caregiver support you have available will help the care team determine what goals will be prioritized during your stay. It will also help inform a safe discharge plan.

INDEPENDENCE

The Next Steps to HOW LONG WILL I STAY?

Caregivers may be your spouse, family members, friends, and members of your church or community. They may even be hired through an agency. We will provide training to you and your caregiver(s) during your stay to give them the necessary skills and information to safely care for you after discharge.

Keep in mind that even individuals who do not require physical assistance when they leave will likely need some degree of support following discharge. From picking up groceries and medications to transportation to your appointments, having a supportive caregiver ensures the best success at home.

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PREPARING FOR DISCHARGE DISCHARGE MEDICATIONS

MEDICAL SUPPLIES

We will start working with you on your prescriptions before you leave the hospital. There are several ways to fill your prescriptions, including at your local pharmacy or at the Sheltering Arms Institute pharmacy before discharge. Call (804) 578-6384 to speak with our pharmacy team for more details.

Some medications may require authorization from your insurance company, some may not be stocked at all pharmacies, and others may not be covered by your insurance plan; therefore, different medicines may be prescribed. As your discharge date approaches, do not hesitate to ask your physician or nurse about any medications that you are taking and if you will continue taking them after discharge.

If needed, your doctor will write prescriptions for necessary medical supplies. Your care manager will help determine which company you would like to use and will initiate the referral for services on your behalf.

Advance planning with your nurse and physician regarding your prescriptions will help limit stress on the day of your discharge. It will also give us a chance to resolve any problems that may arise when filling your prescriptions.

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Some items may be supplied by a home health company, but others may come directly from a particular manufacturer. Talk with your care manager about your supplies before you leave the hospital to find out what supplies are being ordered for you, where they are coming from, and how they will be paid for.

ADAPTIVE TECHNOLOGY We have several devices you can trial during your stay to help improve your independence at home and in the community. Our specialty trained team members will provide demonstrations, education, and resources to help you determine devices that may be helpful and find ways to incorporate them into your home environment. Please visit our website for more information.

HOME & VEHICLE MODIFICATIONS HOME MODIFICATIONS It’s important to assess your home in preparation for discharge. For example, you may need new equipment such as a hospital bed or wheelchair. Some questions to ask include: • Do you have steps to enter your home?

• Should a ramp be built?

• Are your doorways wide enough to accommodate a wheelchair?

• Can you safely enter your bathroom and kitchen?

• Do you know how you will take a bath or a shower?

• Will you need to add grab bars or other safety devices?

The answers will help your care team customize your home needs.

Your team will help you trial equipment such as wheelchairs and bathroom accessories. As you near discharge, your team will make final recommendations for home equipment, help you learn how to use the devices, and obtain prescriptions for the equipment that insurance covers. The completed prescriptions are sent to a vendor of your choice and facilitated by a team member to ensure timely delivery and proper fit. Equipment may be rented for short-term use or purchased depending on your needs and insurance coverage.

Your equipment can be delivered directly to your home or to the hospital. Our goal is to have your equipment delivered prior to your discharge to ensure everything meets your needs. If your equipment will be delivered to your home, someone will need to be there for delivery. If your equipment will be delivered to the hospital, it must fit in your vehicle for transport home. Certain wheelchairs and lifts may be too tall.

Even if you’re going home in an ambulance, the equipment may not fit inside. Be sure to talk with your team about your equipment and transportation.

VEHICLE MODIFICATIONS As part of your discharge plan, it’s also important to consider any modifications that may be needed to your vehicle to accommodate your needs. You will need to consider how you will get home from the hospital as well as to and from the grocery store, the pharmacy, and appointments. You may have a new wheelchair. If so, consider: • How will you put it in the vehicle?

• Will it easily fit in the vehicle?

• Do you have someone who can lift the equipment in and out of the car?

• Will you need a ramp or a lift?

Your team will help you determine what changes may be required. Sheltering Arms Institute has car transfer simulators that will help you and your team determine safe techniques and any adjustments that need to be made. There are also adaptive driving schools that your care team can recommend.

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DISCHARGE READINESS

CHECKLIST

Make sure to review these important steps with your team and caregiver(s)

UPON ADMISSION (WITHIN 72 HOURS) _______ Complete initial evaluations with your care team, develop goals, and create a care plan. _______ Sign up for the patient portal to access your records. _______ Identify your caregiver(s). _______ Meet with your care manager to review your available insurance benefits and begin to discuss your discharge plan.

Care manager:_____________________ Tel:____________________ Email:____________________________ _______ Begin working with your care team to determine your length of stay and your estimated discharge date.

Estimated Discharge Date:_______________

DURING YOUR STAY (ALL ITEMS MAY NOT BE APPLICABLE) Complete patient and caregiver training for the items below. If your care team determines that an item is not needed, mark “N/A.” _______ Medication education & training: Learn why you’re taking your medicines and what they’re for. Learn when and how you are supposed to take them, including injections. _______ Vent/trach/respiratory education and training: Learn about the respiratory system, the supplies and equipment you’re using, and learn to manage your needs independently. _______ Nutrition education & training: Learn your nutrition needs and how to meet them. Become familiar with any special feedings or supplements, possible diet modifications, swallowing strategies, and learn about any feeding tubes or pumps you’re using. You or your caregiver must learn how to manage your nutrition needs independently. _______ Behavior management/mental health education & training: Caregivers may need to learn about new behaviors as well as mental health challenges and how to manage them. _______ Bowel and bladder education & training: Learn how to manage your bowel and bladder needs and receive training on how to perform the techniques independently. _______ Skin care/dressing change education & training: Learn about your skin-management regimen — such as turning, positioning, and pressure relief — as well as dressing changes and wound care. Learn about the supplies you’re using and how to manage your skin-care needs independently. _______ Safety management education & training: Learn about important safety considerations. Receive training on special techniques such as transfers. _______ Communication & cognitive considerations: Learn strategies for you and your caregiver(s) to enhance communication and improve independence with problem solving and memory.

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AS YOU NEAR DISCHARGE _______ Ensure that your care manager has your correct address and contact information on file. _______ Complete caregiver training and ensure your caregiver is comfortable with techniques and equipment. _______ Discuss with your occupational therapist whether you will need a disabled parking tag. _______ Identify preferred providers for services after discharge (e.g., home health, outpatient services, skilled nursing, independent/assisted living facility, and/or mental health resources). _______ Review your medical equipment needs with your therapy team. Talk about the type of equipment that you will need, how it will be delivered, and how it will be paid for. _______ Review your home therapy program with your therapists. If you will attend outpatient therapy, identify the facility location with your care manager. _______ Inform your care team how you would like to have your prescriptions filled. _______ Discuss plans for your discharge transportation with your care manager. _______ Begin sending home personal belongings to ease your discharge day. _______ Discuss with your caregiver how new equipment sent to the hospital will be transferred home. _______Ensure that your caregiver is aware of our target discharge time between 10 a.m.-12 p.m. If this time frame does not work for you, notify your care manager. _______If you are considering paying for in-home personal care, discuss this with your care manager.

DAY OF DISCHARGE _______Pack up any remaining belongings in your room. Collect belongings stored in the hospital safe, if applicable. _______Ask your nurse for any medications from home that are being stored in the pharmacy, if applicable.

_______Review your discharge paperwork with your nurse. _______Take only equipment ordered specifically for you. Please leave the hospital’s equipment in the room. _______If your discharge plans change, please notify your care team immediately.

AFTER DISCHARGE _______Your recovery continues after discharge. Continue therapy as prescribed. Keep appointments with your physician(s) so that you can continue receiving care and needed prescriptions. _______Ensure that you are aware of your follow-up schedule and comply with recommendations. _______Expect a courtesy call from Sheltering Arms Institute asking how you are feeling after discharge. _______Complete the patient satisfaction survey, which you’ll receive by mail a few weeks after discharge.

Your feedback is very important to our team members. _______Engage with community partners and support groups.

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We want to know

ABOUT YOU Your treatment is customized based on your goals, interests, and hobbies. The more we know about you, the better we can create a meaningful care plan to maximize your outcomes. For example, let us know if you love to fish, play golf, travel, or simply spend time with loved ones.

I am close with my: (Friends)______________________________________________________________________________ (Family)_______________________________________________________________________________ (Pets)_________________________________________________________________________________

My hobbies are: _____________________________________________________________________________________ _____________________________________________________________________________________

My favorite music is: _____________________________________________________________________________________ _____________________________________________________________________________________

My recent work history is: _____________________________________________________________________________________ _____________________________________________________________________________________

Other things to know about me: _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________

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COMMUNITY PARTNERS As part of our mission, we give back to the community by supporting and partnering with other local nonprofits to extend our continuum of services. Additionally, we are fortunate to welcome several of our partners to the Sheltering Arms Institute campus to assist in mentoring patients directly to ensure they have, or are connected with, needed resources before returning to the community.

Our partner organizations offer specialized services, accessible housing and ramps, recreation, peer mentoring and support groups, and much more.

CLICK HERE to learn more about our community partner resources

The following organizations are official community partners of Sheltering Arms Institute: COMMUNITY PARTNER

WEBSITE

CONTACT

Amputee Coalition

amputeecoalition.org

(888) 267-5669

Brain Injury Association of Virginia

biav.net

(804) 355-5748

Community Brain Injury Services

communitybraininjuryservices.org

(804) 386-0925

Department of Rehabilitation & Aging Services (DARS)

dars.virginia.gov

(804) 662-7093

RVA Aphasia Group

rva-aphasia.com

info@rva-aphasia.com

Sheltering Arms Fitness, Recreation shelteringarms.com & Wellness

(804) 764-5275

SAI Limb Loss Support Group

shelteringarmsinstitute.com

(804) 837-8129

SAI Stroke Support Group

shelteringarmsinstitute.com

(804) 837-8129

Sportable

sportable.org

(804) 731-7298

United Spinal Association

unitedspinalassociation.org

(800) 962-9629

United Spinal Association of Virginia

unitedspinal.va.org

(804) 803-3696

VCU Health

vcuhealth.org

(804) 828-4097

Virginia Assistive Technology Systems (VATS)

vats.virginia.gov

(804) 662-9990

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OUTPATIENT Continuing Care 14

OUTPATIENT SERVICES

PHYSICIAN SERVICES

Your care team will evaluate your needs and make recommendations on the type of service(s) you may need after discharge from hospital rehabilitation.

Your doctor at Sheltering Arms Institute may suggest that you continue to see a PM&R physician on an outpatient basis.

These services may be provided by: • Home health care • A skilled nursing facility (SNF) • A post-acute or residential program • One of Sheltering Arms Institute’s outpatient locations across Central Virginia • An outpatient therapy center in your community

If you live in the Central Virginia area, your referral will specify if and when to see your VCU PM&R physician. Call (804) 828-4097 to schedule your appointment or, if you prefer, we can make the appointment for you.

If you live outside of the Richmond area, we can refer you to a PM&R provider close to home.

You always have a choice when selecting providers for the services that you receive. If you have a preferred provider, please tell your care manager. Otherwise, we can provide suggestions within your insurance network. Please note that the amount and type of services suggested may depend on your insurance coverage.

SHELTERING ARMS INSTITUTE OUTPATIENT PROGRAMS AND SERVICES • Amputee Care

• Pain Management

• Aquatic Therapy

• Parkinson’s Disease

• Balance and Fall

• Pelvic Health

Prevention

• Physical Therapy

• Concussion Services

• Post-COVID

• Critical Illness Recovery

• Post-Surgical Recovery

• Developmental

• Pregnancy Recovery

Disabilities • Driver Readiness • Dry Needling • Industrial Rehabilitation

• Speech-Language

Pathology • Spinal Cord Injury

Recovery

• Joint Replacement

• Stroke Recovery

• Multiple Sclerosis

• TMJ Therapy

• Neurological

• Traumatic Brain Injury

Rehabilitation

• Vestibular Therapy

• Occupational Therapy

• Video Motion Analysis

• Orthopedic

• Wheelchair Assessments

Rehabilitation

OUTPATIENT CARE TEAM Physical therapists specialize in treating neurological or orthopedic conditions. Through a broad range of treatments, they help patients find relief from pain and recover independence.

Occupational therapists help patients practice activities of daily living from dressing and grooming to meal planning and money management to promote independence.

Speech-language pathologists diagnose, treat, and prevent disorders related to swallowing and communication.

To request an outpatient therapy appointment at one of our convenient locations listed on the back cover, please call (804) 764-1000 or visit www.ShelteringArmsInstitute.com.

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Sheltering Arms Institute is a nonprofit entity that pursues public benefit and community support through donations, fundraisers, and grants. For more than a century, Sheltering Arms has served the healthcare needs of our community, and it has been the generous community that has kept our legacy strong.

Our team members are grateful to be part of each patient’s journey to help them find their power to overcome. To celebrate this journey, the Foundation implemented an initiative called Project Gratitude, which offers a special opportunity for patients and their family members or caregivers to recognize the individuals who provided care and support needed throughout recovery.

Should you wish to make a gift in honor of a team member, please contact the Foundation:

Helping People Find the Power to Overcome 16

(804) 342-4141 Foundation@ShelteringArms.com

L O C AT I O N S MAIN CAMPUS

2000 Wilkes Ridge Drive Richmond, VA 23233 B O N A I R* 206 Twinridge Lane Richmond, VA 23235

Main Campus Rehab Hospital Outpatient Therapy

HANOVER Reynolds

Fitness/Pool: (804) 764-5275

Hanover Midtown

CHESTER 12220 Iron Bridge Road Suite C Chester, VA 23831

Bon Air

Laburnum

RICHMOND

HENRICO

H A N O V E R* 8226 Meadowbridge Road Mechanicsville, VA 23116

CHESTERFIELD Hull H Street C Chester

HULL STREET 13530 Hull Street Road Midlothian, VA 23112

To request an outpatient therapy

L A B U R N U M*

appointment, please call (804) 764-1000

4730 S. Laburnum Avenue Richmond, VA 23231

or visit ShelteringArmsInstitute.com.

M I D T O W N & C L U B R E C* 2805 West Broad Street Richmond, VA 23230 R E Y N O L D S* 6627 West Broad Street Suite 100 Richmond, VA 23230 * Offers Fitness, Recreation & Wellness Services