Levels of Care

The Acute Rehabilitation Unit (ARU) at Madonna Rehabilitation Hospital is designed to assist children and adults with rehabilitation diagnoses, such as brain injury, spinal cord injury, stroke and other orthopedic or neurological illnesses/injuries, to reach as high a functional level as possible and to regain the ability to do those things that are important to them.

To be eligible for admission to ARU, the program must have:

1. A documented diagnosis of stroke, spinal cord injury, congenital deformity, amputation, major multiple trauma with or without brain or spinal cord injury, brain injury demonstrating at least a localized level of response (Rancho Level III or higher), neurological disorders with significant functional deficits, burns, post-operative surgery (including orthopedic surgery) and other diagnoses considered on a case by case basis
2. Need for 24 hour availability of a physician and registered nurse with experience and/or training in rehabilitation
3. Need for at least two of the following services: physical therapy, occupational therapy, speech therapy, and/or orthotics/prosthetics, three or more hours per day, five days per week

Patients on ARU receive a wide array of services, including physical, occupational, speech, recreational, respiratory and nutritional therapies, rehabilitation nursing, rehabilitation psychology, spiritual services, diagnostic services, medical services, orthotics/prosthetic services, case management, social work, and other services depending upon the needs of each individual served. Therapies are provided, on average, 3 hours per day during weekdays with supplemental services on the weekend. Registered nurses with rehabilitation training or experience are involved with patients on ARU 24 hours per day, 5 days per week. Physicians with specialty in physical medicine and rehabilitation (called "Physiatrists") are also available 24 hours per day, 7 days per week.

Madonna serves children and adults with a wide variety of activity limitations and participation restrictions on its ARU. Cultural diversity is respected. Most patients transfer to Madonna ARU directly from an acute care hospital. Appropriate patients are medically stable and have medical and rehabilitation needs that require the availability of a physician and nurse with rehabilitation experience 24 hours per day, seven days per week. Patients must be willing and able to actively participate and benefit from an intense rehabilitation program and have potential to make significant functional improvement. Madonna accepts funding from Medicare, Nebraska Medicaid, and most commercial payers. Out of state Medicaid and charity care cases are considered on an individual basis. A majority of persons served on ARU are discharged to a community setting. For more information about outcomes, please click on the Outcomes section.

Other medical services at Madonna include:

Pharmacy: Madonna's in-house pharmacy is open Monday-Friday 8 a.m. to 10 p.m. and
8 a.m. to 4:30 p.m. on weekends and holidays. During closed hours, a pharmacist is on call. Madonna provides a full range of inpatient pharmacy services, including medication distribution (both oral solids and IV preparations), patient education, clinical/dosing services, drug information, and participation in several hospital committees. Madonna does not supply take home medications for patients and patients who require parenteral chemotherapy are sent out to a patient infusion center for that service.

Respiratory Therapy: Madonna provides respiratory therapy 24 hours per day, seven days per week using Madonna staff who are licensed respiratory care practitioners. Madonna's respiratory therapists provide ABG services. Pulmonologists are able to perform bronchoscopies on-site with assistance from respiratory therapy staff.

Laboratory: Madonna's in-house laboratory is open from 7 a.m. to 7 p.m., Monday - Friday and 7 a.m. to 3:30 p.m. on weekends and major holidays. Outside of these hours, STAT laboratory analysis is available through contract testing with an acute care hospital. Madonna's laboratory provides anticoagulation, hematology, chemistry, therapeutic drug level testing and urine analysis services. Additional testing, if necessary, is provided by Madonna’s reference lab Physicians Laboratory Services. Most general lab tests are performed by Madonna staff and results are available the same day. Send-out tests, such as cultures or less common tests, are resulted within 3-5 days.

Radiology: Madonna provides limited in-house radiology services, including X-ray, Ultrasound, Echocardiogram, Venous Doppler, Arterial Doppler, Holter Monitor, Sleep Study and EEG. CT scans, MRI scans and any other comprehensive radiology exams are performed at one of the medical facilities in Lincoln. Regular hours for Madonna's radiology department are 8:00 a.m. to 9 p.m., Monday-Friday and 8:30 a.m. to 5 p.m. on weekends. Patients are transported to one of the medical facilities in Lincoln if they require services after those hours. Results of in-house Radiology testing are interpreted by Radiology Associates, PC and in most cases reported the same day.

Patients are ready for discharge when:

1. Educational, medical and rehabilitation goals are met
2. No additional medical or functional improvement is anticipated (patient's condition is chronic)
3. The health and/or safety of other patients or staff is jeopardized
4. Patients are unwilling to participate in or comply with the program
5. Patient develops a medical condition/complication that requires intense services in an acute care hospital
6. Patient has made significant progress to allow placement in a lower level of care and such placement is available
7. Patient/caregiver demonstrates ability to manage the discharge plan of care, specific to the patient's condition and needs, including management of treatments and follow-up

To read more about each of Madonna's specialty programs, please click on the links below:

• Adaptive Sports & Recreation Program
• Adolescent & Children Rehabilitation Program
• Amputation Program
• Aquatics
• Brain Injury Program
• Burn Program
• Driver Rehabilitation
• Neurological Program
• Orthopedic Program
• Spinal Cord Injury Program
• Stroke Program
• Technology
• Vision Rehabilitation Program