Q&A with Steve Schaefer: Rehab hospital gets patients back on their feet

Memorial Health System and Penrose-St. Francis Health Services are not the only hospitals in town.

Steve Schaefer, CEO of HealthSouth Rehabilitation Hospital of Colorado Springs, calls his hospital the best-kept secret in Colorado Springs.

“This hospital is actually 20 years old,” Schaefer said. “People don’t quite know about us.”

A rehabilitation hospital works with patients after they leave an acute-care facility like Penrose and Memorial and provides intensive, in-patient physical therapy to figuratively and literally get them on their feet again before sending them home or to a less-intensive care facility. HealthSouth is a for-profit company that owns about 100 rehabilitation hospitals across the country.

Schaefer, 45, spent 11 years at Memorial and served as the hospital’s vice president for strategic development before coming to HealthSouth in 2008. Thanks to a change in Medicare and Medicaid rules at the time that limited who could be admitted to in-patient rehabilitation facilities, HealthSouth had only eight patients his first month. Now the average census is 25 to 30 patients a day and the 43-bed hospital is on much sounder financial footing.

Schaefer spoke with The Gazette about how a rehabilitation hospital works and how his hospital is adapting to the rapidly changing health care business.

Question: Tell us more about what a rehabilitation hospital does.

Answer: Patients who come to us are typically those with neurological issues, orthopedics and brain injuries. We also see a fair amount of deconditioning with the elderly population. The requirement for a rehab hospital is you have to be able to participate in three hours of rehab a day.  I consider it a compassionate boot camp – we work our patients hard, but with a lot of TLC.

Q: How long do patients stay with you?

A: The average stay is about 12 days.

Q: How many patients do you have and how many staff?

A: We average 60 to 70 admissions a month. A typical census is 25 to 35 patients. We have 115 people on staff.

Q: Where do your patients come from? And what insurers pay for their care?

A: : We get a fair amount from the acute-care hospitals. We started a home referral program; it’s been really, really successful. There’s such a huge population that is borderline if it’s safe for them to be in their house or not.

We bring them in for a couple weeks, get them stronger and assess their medical needs, and get them to the point they are safe to return to their homes. We have physicians and seniors themselves calling us for evaluations.

Q: You mentioned how regulatory changes had hurt the hospital when you started. How did you deal with that?

A: We really focused on streamlining; we revamped operations. The hardest thing, but the most rewarding thing is, we’ve had a total cultural transformation here. Employees have gone from worrying about their jobs to, now they know the hospital is successful, they’re saying ‘What can we do next?’

Q: How did those changes restrict your patient base?

A: Rehab is very different from the standpoint of how we accept a patient. A qualified reviewer, a nurse or a therapist, needs to go to review the patient and then a physician needs to agree with that review. Sixty-five to 70 percent of the patients that get referred to us actually get admitted. We just can’t take any patients to our hospital. The therapy staff has to see a patient 15 hours a week. It’s really stringent with what allows a patient to come to rehab hospital and what allows them to stay here.

Q: How will health care reform affect HealthSouth?

A: President Obama said the post-acute market was out of control from a spending perspective. The post-acute market is not out of control — there are areas within the post-acute market that are elevating costs. The rehab market has bent the curve. We have been flat with regard to Medicare expenditures since 2003.

We know everyone has to step up to the plate (but) we don’t want resources taken away from the rehab industry when we’re showing results. We would like a pat on the back for bending the curve on costs while elevating care at the same time.

We can get people back so they’re safe in their homes and not coming back to emergency rooms. We’ve figured out a way to be very cost efficient at this hospital.

Q: What’s next for you at HealthSouth?

A: On Feb. 10, we have a survey by the Joint Commission —we applied about a year ago to become a Stroke Center of Excellence. I know our staff does a phenomenal job with our stroke patients; this will validate it for the community.

The more we can do to formally recognize the great work of the staff, the easier it will be to get the word out to the community.

Q: What other things are you doing to differentiate your hospital?

A: We worked with The Resource Exchange and Peak Vista Community Health Centers to develop a new model for meeting the needs of the developmental disabled population. Phase one is complete with the new medical clinic opening in 2011. In 2012, we will open a health and wellness clinic at HealthSouth that will be geared towards all specialty populations.

Q: Health care is evolving. What other changes are you making in order to keep up?

A: We have had to change our delivery model. We opened “Concierge Suites” last year to meet the needs of patients wanting additional amenities. We also have revamped food service for patients and employees. Now, our employee café is packed at lunch time due to the great food provided by our chefs. Happy employees translates into happy patients!  

Q: Why did you get involved in health care?

A: My family has been involved in health care. My grandfather was a doctor in Minnesota. It skipped a generation and in my family, my sister is an audiologist, my other sister is a physical therapist and my brother is a Web designer for a children’s hospital in Atlanta.

This type of health care is fun because you get to see people get better and celebrate with them. It’s rewarding to do this kind of work.