HOWLAND TOWNSHIP, Ohio – At Hillside Rehabilitation Hospital, most patients want to be independent by the time they leave, says Jeffrey Koontz, director of rehabilitation services.
Hillside, at 8747 Squires Lane NE in Howland Township, is a 69-bed acute rehabilitation hospital that has three therapy gyms, and has operated for more than 55 years. Steward Health Care System acquired the hospital when it bought ValleyCare Health System of Ohio in 2017.
With 244 employees, including 72 on the therapy staff, at the main campus, Hillside offers inpatient and outpatient rehab services that comprise physical, occupational and speech therapies. The outpatient services, which require a prescription, are delivered at Austintown Rehabilitation Services in Austintown, which has a staff of 23, as well as at the Hillside campus in Howland.
“Most patients want to be able to get back to the life they had prior to whatever illness or injury occurred to them,” Koontz says. “And so that is our goal. Our goal is to get that patient at the highest functional level possible before they’re discharged from Hillside.”
A physical therapist for 13 years and at Hillside for 10, Koontz got interested in the field when having to undergo physical therapy for ankle injuries while playing football. After being exposed to the various types of therapy during his education, inpatient rehabilitation “just really stuck with me,” he says.
At Hillside, patients receive more intense, one-on-one therapy unique to the patient than they would at a skilled nursing facility, according to Trish Hrina, regional marketing director for Steward.
“One of the biggest challenges is getting the patient to know that they’re going to come here to a more intense environment and be able to commit to that,” she says. In many cases, patients who come here aren’t “really well off,” she says.
“We are unique because we give patients three hours of therapy a day and this is very intense therapy,” says the lead physical therapist, Karen Hartman.
Hartman, who has worked at Hillside for more than a decade, works primarily with neurologic patients such as stroke victims, as well as with those with brain or spinal cord injuries, general debility and cardiac diagnoses. Much of that work involves repetition, sometimes breaking actions into segments to make it easier for them to relearn an activity.
“It’s teaching them to do something that they used to know how to do and now they aren’t able to, even just getting out of a chair,” she says. “That’s something that’s easy for you or me. But they might need it broken up into parts to relearn how to do that.”
Hillside draws from “a pretty big radius,” Koontz says. In addition to its primary market area in the Mahoning Valley, it receives referrals from the Cleveland Clinic and University Hospitals in Cleveland, as well as the Akron and Pittsburgh markets.
“We do get patients from [University of Pittsburgh Medical Center] so it is a pretty large circle that we cover,” he says.
“We basically work on their function – what do they need to do to go home – so that involves walking if they’re able to walk, strengthening exercises, endurance training,” Hartman explains. “We talk to the families to find out if they’re able to come in for instructions or we do it over the phone to make sure that they’re able to manage the patient’s needs when they go home.”
The daily inpatient census ranges between 45 and 50, while outpatient therapy sees upward of 300 visits weekly, Koontz reports. People recovering from strokes represent Hillside’s largest volume of patients, about 30%.
From there, the patient population is made up of people who suffer brain injuries in car accidents or falls and spinal cord injuries, as well as post-surgical patients for procedures such as joint replacements.
Typical length of stay is 14 days, based on the patient’s progress, Koontz says. Some might stay for a week while other stays could be upward of a month.
Stays sometimes are constricted by what a patient’s insurance coverage will permit, Hrina says.
“With us being an acute rehab, it’s a barrier just to get into Hillside,” she continues. “It’s a lot easier for insurance to deny a place like Hillside and send you to a skilled nursing facility where you get group therapies and faster therapies.”
Some of the more specialized rehab services at Hillside include lymphedema management and treatment, for patients experiencing excessive swelling and fluid in their extremities, Koontz says. Hillside also performs modified barium swallow studies to see how well patients can swallow and what kinds of liquids they can tolerate, something that is important for post-stroke or post-brain injury patients, he says.
About 70% of Hillside’s patients return home, which Koontz says is above the national average for an inpatient rehab center.
“We do take some of the hardest-hit patients here at Hillside. So that does play into some of our percentage of patients who do and are able to return home,” he says. Family support also is a “huge” factor, he adds.
“There will be patients that need an extensive amount of care and we would be apprehensive to send them home that way,” Hartman says. “Some people don’t have anyone to go home to and we have to do a lot of extra planning for those patients to make sure that they’re taken care of.”
The coronavirus pandemic has provided additional challenges. Physical, occupational and speech therapists “are very used to being connected to that patient and sometimes we have to be to help them walk, to help them eat,” Koontz says.
When meeting with patients, staff wear all of the appropriate personal protective equipment, including eye protection, and follow Centre for Disease Contrl and Prevention and Ohio Department of Health guidelines for PPE use. They sanitize equipment before and after each patient treatment.
The growth of in-house rehab centers in nursing homes, assisted living centers and other health care operations present competition for the hospital. Even so, Hillside’s admissions have grown 17% since 2017, Hrina reports.
“Competition is good.” Koontz says. “It makes us strive to be the best that we are,”
Most of Hillside’s therapists have been at the hospital for more than 10 years, many more than 20, Hartman says.
“They stay here because they like what they do,” she says. “We do provide that three hours of therapy a day that other facilities don’t. So we see our patients get better. That’s rewarding for us.”
Pictured: Karen Hartman is the lead physical therapist. Jeffrey Koontz is the director of rehabilitation services.