2023-24 Outcomes

Beechwood NeuroRehab Quality Improvement Plan (QIP)

July 1, 2023 through June 30, 2024

 

Introduction- History and Description/Scope of Beechwood NeuroRehab

Woods Services has a rich history of serving children and adults with neurological disabilities over a span of the last 100 years. Woods services provides residential, educational and vocational supports for over 600 people with intellectual disabilities, autism, developmental disabilities, and acquired brain injury. In 1979, Woods first established the brain injury program now known as Beechwood NeuroRehab. The program came about due to the need to provide specialized services to meet the needs of individuals who sustained a brain injury. Throughout our history, the program has grown and evolved, providing specialized services to thousands of adults. Beechwood NeuroRehab is regarded as one of the nation’s premier brain injury rehabilitation programs, and has maintained CARF accreditation since it was first applied for in 1994. The areas of accreditation include the following Brain Injury Specialty Programs: Outpatient Medical Rehabilitation Program, Residential Rehabilitation Program, Vocational Services, and Home & Community Services.

 

In its fourth decade, the program continued to evolve with the development of supported employment and the transdisciplinary neurofunctional approach. The addition of a Brain Injury Clubhouse program and the InSPIRE program further enhanced the wide array of services for which Beechwood NeuroRehab has come to be known. Our ability to serve individuals with a range of functional levels is a hallmark of our services, enabling those individuals to move through a continuum in order to achieve their highest level of capability for meaningful life roles.

 

Residential options range from Community Residences with 24 hour/7 day per week supports, to Community Residences with less intense supports, and Supported Apartments in the community. This continuum helps ensure that each individual receives just the right amount of supports for living. A broad range of clinical rehabilitation services, structured day program, and vocational services, as well as medical, nursing, and care coordination supports distinguishes Beechwood NeuroRehab Services as one of the premier east coast providers of brain injury rehabilitation. Vocational, Structured Day Programs and clinical services also are available to outpatients living in their own homes in the surrounding communities. All rehabilitation plans are person centered, individualized, and each person is served by a transdisciplinary team of brain injury professionals.

Our Mission

Beechwood supports persons with acquired brain injury and other neurological disorders reach their highest potential through innovative approaches through individualized person-centered programming that promotes personal fulfillment and participation in their communities.

 

Vision:

Through the application of innovation and the setting of new standards of excellence in brain injury rehabilitation, we envision a world where all individuals impacted by acquired brain injury can experience fulfilling life roles and the ability to maximize community assimilation.

 

Philosophy:

Beechwood’s philosophy is to provide comprehensive rehabilitation to adults with acquired brain injury by incorporating innovative treatment concepts along with the application of technology and evidence-based techniques. Beechwood employs a person-centered, transdisciplinary approach emphasizing the development of restorative and compensatory strategies to maximize each individual’s ability to participate in meaningful roles within a community setting.

Persons Served

Post-acute NeuroRehabilitation services are offered to persons 18 years and older who are medically stable and who need services and supports to maximize performance in everyday life or who need supported living. Individuals served have acquired disabilities cause by either traumatic or non-traumatic injury to the brain, which is the result of trauma, surgery, tumor, anoxia, stroke, or other neurological disorders. The persons served may demonstrate a wide range of cognitive impairments and emotional or behavioral challenges.

Discharge/Transition Along the Continuum

• Discharge/Transition planning begins at admission.
• Persons served are advanced along the continuum as soon as they are able.
• Readiness for transition along the residential continuum from Community Residential to Supported Apartments is tested by the Readiness Checklist which is completed by each individual’s transdisciplinary team.
• Readiness for transition along the vocational continuum from Structured Day to BeechTree Enterprises to Supported Employment is assessed using the Vocational Rating Scale (VRS) which is completed by each individual’s transdisciplinary team.

Funding – Funding may include:

• Auto Insurance
• Workers’ Compensation
• Legal Settlements or Trust Funds
• Commercial health insurance
• Community Health Choices or OBRA Waiver
• Pennsylvania Department of Health Head Injury Program (PHIP)
• Office of Vocational Rehabilitation (OVR)
• Medicare/Health Insurance

Locations:

Beechwood NeuroRehab’s administrative offices are located at 469 E. Maple Avenue, Langhorne, Pennsylvania, 19047. The adjacent Stabler NeuroRehab Center houses the Clubhouse and InSPIRE Programs as well as NeuroRehab Therapies and the home base for Supported Employment. Next to Stabler Center is the Health & Wellness Center, and there are 9 Community Residences nearby, as well as an apartment complex with 16 apartments within a short drive. All residential participants enjoy easy access to the surrounding towns of Langhorne and Bensalem, and full participation in the life and events of the Greater Philadelphia community.

Demographics – Characteristics of Persons Served

Persons Served by Major Program Category: As of 12-31-2023, there were a total of 114 persons served enrolled at Beechwood NeuroRehab. Approximately 68% are served in Beechwood NeuroRehab’s Community Residences, and also receive services NeuroRehab Therapies, Structured Day, and Vocational Programs. Another 32% are non-residential clients who live in their own homes in the community, and also receive services NeuroRehab Therapies, Structured Day, and Vocational Programs.

 

Approximately 80% of all Beechwood NeuroRehab’s persons served participated in some level of NeuroRehab Therapies, Structured Day, or Vocational Programs. In addition to having this productive activity outside their homes, 100% of clients served in Residential programs receive an individualized schedule of Life Skills Training and Recreational Activities designed to maximize their participation in home and community living.

 

Persons served by Gender: Approximately 62% of all persons served are male and 38% are female. This is consistent with the gender counts from the previous reporting year.

 

 

Persons served by Current Age: Beechwood NeuroRehab has 2% of its persons served in the 19-29 years of age bracket, compared to 5% for our peer post-acute benchmarking providers. The numbers in this age bracket has seen a recent decrease. Beechwood NeuroRehab continues to be similar to our peer post-acute benchmarking providers in the 30-44 years of age bracket (26%, compared with benchmark providers’ 24%) as well as the 45-60 age bracket (35%, compared with benchmark providers’ 39%). Adding in the older adults, 72% of people served by Beechwood are over 45 comparable to the 71% over 45 for benchmarking providers. This is a recent change in trends for Beechwood as in the past over 45 was predominantly a higher percentage over benchmarking providers.

 

The previous higher percentage of people over 45 served at Beechwood NeuroRehab represented persons served who were originally admitted under the former auto no-fault auto insurance coverages that paid for life-long services and who are aging-in-place in the program. These coverages no longer exist, and people injured today most often go home with family members or are sent to nursing homes. The higher percentage in Beechwood NeuroRehab’s over 45 population in the past was also the result of a generally aging population and better funding sources that Pennsylvanians could access decades ago. Public funding is becoming more and more common and much advocacy effort was placed on rate review to ensure continued availability of Residential Habilitation providers for brain injury. 

                                                                   

Types of Brain Injury: Approximately 80% of the Beechwood NeuroRehab population sustained a closed traumatic brain injury, and 5% were open traumatic brain injuries. Other non-traumatic causes accounted for 5% and anoxia accounted for 7% tracking similarly to other benchmark providers. There has been a noted increase in anoxia compared to previous years.

 

Persons served by Funding Type:

Approximately 26% of Beechwood NeuroRehab’s persons served are funded by former Auto No-Fault Insurance, compared to only 8% auto among Benchmark providers. Approximately 65% of Beechwood NeuroRehab’s persons served are funded under the Public funding, compared with 59% among Benchmark providers. This is an increase in Public funding for the Benchmark providers. Benchmark providers are seeing only 1% through the Veterans Administration.

 

Admissions and Discharges:

In the 2023-2024 year Beechwood NeuroRehab had a total of 24 referrals. This is a decrease from the previous year with 39. Of the 24 referrals, 2 participants were admitted. There was a total of 9 denials for reasons such as non-compliance with rehab, criminal charges, and no funding. Seven of the referrals were closed for reasons of no vacancy, no funding, inactive in referral, or found alternate placement. One participant was placed on a waitlist and 5 were still active in the referral system as of July 31, 2024

 

Demographics – Implications for Program Development:

Seventy-two percent of Beechwood NeuroRehab’s population is over 45, and are more subject to experience the “disease-accelerative” effects of brain injury. This statistic reflects the fact that many Beechwood NeuroRehab persons served were injured a long time ago, under different resource systems that younger people cannot access today. This analysis the following program development implications:

Advocacy:

Beechwood NeuroRehab is a leader in the industry in promoting advocacy. Many of our staff are involved with Brain Injury Association of America, the Pennsylvania Department of Health, Brain Injury Advisory Board, and the Brain Injury Association of Pennsylvania. Without a strong advocacy commitment, the field of brain injury rehabilitation would not be where it is today, and Beechwood NeuroRehab has been involved from the beginning. However, much work needs to be done as our national advocacy organization estimates that only 5% of individuals with brain injury have the resources available to get their needs met. Beechwood NeuroRehab is active not only in statewide activities but also on a national level. Some of the specific advocacy activities conducted include:

• Representation on statewide and national boards of directors for brain injury associations
• Presentations at educational conferences
• Organization and participation in brain safety fairs for prevention
• Support of fund-raising efforts through sponsorships
• Providing testimony to Congress, and participation and implementation of legislative activities, both statewide and nationally
• Representation on the Pennsylvania Head Injury Program Peer Review Committee
• Active participation in the statewide provider’s associations
• Encourage and facilitate participation of the individuals served and other stakeholders to become active in advocacy efforts

Advocacy Goals and Objectives for 2024-2025

Increase participation in lifelong learning opportunities for participants and their families by offering brain injury relevant resources and programming geared towards building a culture of empowerment and inclusivity.

1. Increase participant and stakeholder attendance by 10% at annual Brain Injury Awareness week presentations.
2. Increase participant and stakeholder attendance by 10% and annual Mind Your Brain event