The goal of Madonna’s Brain Injury Rehabilitation Program is to help the individuals we serve become as independent as possible after their injury. Madonna strives to establish a partnership for life that the patient and their family can depend on throughout their recovery and beyond. Programming is highly individualized, dependent upon each individual’s needs and personal goals. Family members are encouraged to be actively involved in therapy and nursing care so they may reinforce learning new skills.
We serve survivors with traumatic or non-traumatic brain injuries of any severity. Madonna’s continuum of care serves patients with brain injury who may be emerging from coma (Rancho Level II or higher) to those who are actively participating in their rehabilitation, all the way through their last stages of rehabilitation focusing on return to home, community and work re-entry skills. Madonna Rehabilitation Hospital is one of the only hospitals in the region to be accredited by CARF, the Rehabilitation Accreditation Commission, as a Brain Injury Rehabilitation Program for multiple levels of care, including acute rehabilitation, intensive outpatient and traditional outpatient. Throughout Madonna’s continuum of care, the brain injury program specializes in recognizing, assessing and treating conditions related to brain injury and preventing complications related to brain injury. Our program also focuses on educating patient and families on prevention and reducing the risk of future brain injuries.
Madonna is one of only seven organizations in the U.S. which is accredited in both Brain Injury and Pediatric Specialty Programs. This means that Madonna meets higher standards relating to staff training, programming, patient and family education, advocacy and outcomes management.
Madonna admits patient from multiple in-state and out-of-state trauma systems and acute care hospitals. In Madonna’s 2019 fiscal year, we served 1500 individuals with brain injury across the continuum of care. Outpatients are referred to our services from a variety of physician specialties. A referral from a physician is required to access Madonna’s continuum of care.
Scope of services
Madonna’s Brain Injury Program is comprehensive, providing a wide array of services including physical, occupational, speech, respiratory, recreational and nutritional therapies, rehabilitation psychology, neuro-optometry, case management, social work services, spiritual care services and orthotics/prosthetics as needed. In addition to these specialties, rehabilitation nursing and access to a physician with training in physical medicine and rehabilitation is available 24 hours per day, seven days per week on an inpatient basis. These specialized services are available throughout our continuum of care including Long Term Acute Care, Acute Rehabilitation, and Rehabilitation Day Programs. Family members and caregivers for the persons served are provided with structured training and education on brain injury and providing care for their loved one. Education topics include: deficits experienced post brain injury, understanding the rehabilitation process, risks associated with brain injury, long term resources, aging with brain injury, relationships after brain injury and multiple others. Family and patient preferences are solicited and used as part of the rehabilitation process. Families and caregivers are involved in developing an appropriate discharge plan. They are provided resources to help access life-long care as needed. While most of our patients with brain injury are discharged to a community setting, patients who need additional time in a more structured, residential setting after discharge are also served.
Fees of Service: Cost of care is determined by diagnosis, level of care, acuity of care and length of stay. For more information on fees of service please see: https://www.madonna.org/admissions
Madonna accepts patients with a wide variety of funding, including Medicare, Nebraska Medicaid, commercial insurances such as Blue Cross and Blue Shield, worker’s compensation, and will consider out-of-state Medicaid and non-funded patients on a case-by-case basis.
Clinical Expertise: Each patient’s care is directed by a physician who specializes in physiatry and/or a physician with specialization in internal medicine. A pediatrician is involved in the daily care of individuals 18 years or younger. All Madonna nurses are specially trained in providing care for patients with brain injury, and several Madonna nurses have specialty training as a Certified Rehabilitation Registered Nurse. For very low-level patients, weaning them from a mechanical ventilator might be the first part of treatment. Madonna’s Pulmonary Program has an excellent track record for successful weaning. Patients requiring specialized services and interventions such as cardiology, pulmonology, and orthopedics are referred and provided the appropriate medical and follow up services.
Rehabilitation: Madonna’s dedicated team complete special competency and nationally certified training in treatment of persons with brain injury. The team, consisting of physical, occupational, speech, recreational and respiratory therapists, as well as neuropsychology, social worker, rehabilitation nurse and case manager, work together to meet the complex physical, cognitive, social and emotional needs of persons with brain injury. On average, patients receive three hours of therapy on an acute rehabilitation level of care. Madonna’s therapy staff is also trained on coma stimulation to assist in arousing patients in a disordered state of consciousness. Madonna has a full staff of specially trained rehabilitation psychologists on site who are an integral part of the rehabilitation team. They participate in team meetings, lead behavioral intervention plans and provide counseling and support for both the patient and their family members.
Days and hours of Service: Monday-Fridays. Patients receive assigned hours of therapy appropriate for their level of care and function. Nursing and physician services provided within the scope of the brain injury program are provided 24 hours a day, seven days a week on an inpatient basis. Saturday and Sunday therapies provided on an as needed basis for inpatient therapies.
Environment: Madonna’s environment is designed and specialized for the brain injury populations. Patients with a recent brain injury may go through an agitated and restless stage in their recovery. Madonna has the capacity to lock sections of the brain injury rehabilitation unit to provide better security for patients as they emerge from coma and go through this stage of recovery. Madonna also provides one-on-one supervision and video monitoring as needed for patient safety. Adolescents and children 18 years or younger are admitted to The Alexis Verzal Children’s Rehabilitation Unit. These children are provided rehabilitation in a dedicated, secure area designed specifically for children and adolescents.
Therapy can also be provided in a community setting. Therapists integrate functional activities in these areas to prepare patients for real-life activities in their home community.
Community Re-Entry: Rehabilitation does not stop when the patient gains basic skills of self-care and mobility. Participation in community activities is also an important part of the recovery process and is integrated into therapy sessions. Recreational therapy provides a variety of adaptive sports and recreational outings to help patients and families recognize that they can still participate in enjoyable activities. Patients may also work on specific goals related to return to driving, school re-entry, or visit with a vocational rehabilitation counselor about work re-entry.
Preparing for Home: Persons served and their caregivers, are provided with a self-care training program based upon principles of self-advocacy and self-direction. Patients, with or without their caregivers, are taught how to direct their care and what to do if emergencies arise. They are provided with opportunities to practice these skills during their stay, often ending with a stay in Madonna's transitional living apartment. This apartment is located on the unit, with easy access to medical staff if needed, with the expectation that a family member or other caregiver will assist with the personal care required during their stay.
Long Term Follow Up: Many individuals with brain injury require intermittent care throughout the rest of their lives. As a national expert in this area, Madonna offers an opportunity for persons who have previously received services to return for a re-evaluation to determine if there are any further needs. Individuals complete a telephone screen, then, based upon the information collected, may be scheduled for a comprehensive assessment, which is customized to their specific needs and includes a physiatrist as well as other clinicians who specialize in the assessment and treatment of persons with brain injury.
Mild Traumatic Brain Injury: Some individuals who have sustained brain injuries are not initially recognized or treated because they are mild. Often the need for treatment may not be identified until months after the incident, when academic, vocational, personal or family adjustment difficulties arise. Madonna is regionally known for its Mild Traumatic Brain Injury services — a comprehensive two-day assessment focusing on medical, physical, cognitive (thinking) and emotional aspects of mild traumatic brain injury. Patients may then receive treatment at Madonna based on the results of the assessment or treatment may be obtained in their local area if appropriate.