“Nobody goes there anymore. It’s too crowded.”
Beloved Yankee player and manager, Yogi Berra, who is remembered for his malapropisms almost as well as for his illustrious baseball career, said it best. And while he was referring to a popular St. Louis restaurant, the same quote could be applied to Helen Hayes Hospital.
Every day I hear from prospective patients or their families who lament, “I want to go to Helen Hayes after my surgery, but the referring hospital says it will be hard to get in.” This hurts my heart, because, as the Director of Utilization, it is my primary mission to ensure that people in need of physical rehabilitation have optimal access to the excellent inpatient services at Helen Hayes. So why does this impression persist?
Ironically, the diversity of disability-specific inpatient units and our three separate levels of care, which afford us the ability to take patients other acute rehabs can’t, contribute to the perception problem. Take for instance the Skilled Nursing Facility at Helen Hayes Hospital. This small, 25-bed subacute rehab unit opened in 2000, in response to the push by insurance companies and government payers to direct more patients from the more expensive acute rehab hospitals into rehab in nursing homes. Considering the advances in many orthopedic surgeries, which resulted in shortened recovery time and reduced incidence of medical problems, this was a reasonable initiative. Unfortunately, the public did not always view a potential nursing home stay as favorably as their payer did, and too often, these short stays became more and more extended, dissipating any anticipated cost-savings.
So, when the Helen Hayes subacute opened, offering 24 hour on-site physicians, registered nurses on every shift, on every unit, lab, x-ray, prosthetics and orthotics, pharmacy on site, and our world class physical, occupational and speech therapists – but at a therapy frequency that allowed a reduced rate – the world flocked to our door! There were many days when the unit was full and unfortunately we had to turn away admissions. Discharge planners at referring hospitals began telling their patients that they couldn’t get into Helen Hayes, far in advance of their discharge dates, to avoid the possibility of disappointment. And to make matters worse, no distinction was made between our small, subacute unit and the other 130 acute and medical beds at the hospital, making it seem that patients couldn’t be admitted to the other units either!
So, what can a prospective patient do to get into Helen Hayes Hospital, if it is the preferred choice? First and foremost, insist that the hospital send a referral. We discharge patients every day. Just because we didn’t have a bed yesterday, does not mean we won’t have one today, or tomorrow. Second, remember that while we may not have a bed on our subacute unit that does not mean that we don’t have a bed on the acute unit that is appropriate for you. Most joint replacement patients who have regular Medicare will quality for acute or med/surg level rehabilitation services. That’s an extra 1-1½ hours of therapy over the subacute level every day. Third, if you have a commercial payer (with no Medicare or Medicaid), even if you are only authorized for subacute, we may be able to board you on another unit, and provide the subacute level of therapy there. Lastly, due to the nature of our subacute unit, we are designed to provide high-quality rehabilitative services to patients who can benefit from a short-stay and return home. We do not accept patients with dementia, complex medical conditions or who require long-term care. Patients with neurological conditions such as a head injury, spinal cord and stroke as well as those with amputations, cardiac, pulmonary and orthopedic surgery should be evaluated for eligibility for our acute units.
I hope this has helped to allay any fear that you need to get past a bouncer and a velvet rope to get into Helen Hayes. There’s just our Admissions Office and you can reach us at (845) 786-4118 with any questions.
So, if you’re told you can’t get into Helen Hayes, you tell them to refer you any way, because to quote another “Yogi-ism,” “It ain’t over ‘til it’s over!”
Director, Utilization Management