Paula Swanton wanted her husband, Jim, to receive the highest level of care possible to help in his recovery after complications from a fall and two strokes.
At the time, his insurance would only cover admission to a skilled nursing facility. However, the local nursing home refused to admit him because of the level of medical care and intensive therapy he required. Jim was still on a feeding tube and was confined to his hospital bed. Frustrated and scared, Paula began to do her own research to find her husband the care he required and deserved.
“We were at the hospital for so long, I just started doing my own research, and I found daily therapy is what he needed,” Paula recalled. “He needed a higher level of care than a nursing home.”
That’s when she found Encompass Health Rehabilitation Hospital of Bluffton, just a short drive from the couple’s home in Hilton Head, South Carolina. As an inpatient rehabilitation hospital, Encompass Health provides patients recovering from stroke and other illnesses and injuries three hours of therapy a day, five days a week from at least two of the following disciplines: physical, occupational and speech therapies.
Getting Insurance Coverage
Paula knew her husband needed the intensive therapy offered at Encompass Health, but Jim’s insurance at the time wouldn’t cover it. Since he required so much medical care, a skilled nursing facility wasn’t an option either. Paula didn’t give up, though. After they left the acute hospital setting, they returned home with home health.
When she continued to reach a dead end with Jim’s insurance company, they switched providers during Medicare’s open enrollment period. His new provider approved him for inpatient rehabilitation.
“We waited it out until the end of the year to change insurance, and then we had our home health agency refer us to Encompass Health,” Paula said. “It was worth the wait.”
Entering Inpatient Rehabilitation
When Jim arrived at Encompass Health, he couldn’t sit up. Eating and talking were also a challenge. Paula said he still required round-the-clock medical supervision. That was another perk to Encompass Health, she said. In addition to intensive therapy, it also provides 24/7 rehabilitation nursing care and frequent physician visits throughout the week.
After an evaluation from his care team, which included therapists, nurses, physicians, a pharmacist, case manager and dietitian, Jim was ready to start his therapy.
After being in a coma for over a month, he had lost most of his muscle mass and was extremely weak. His physical therapist worked with him to build back his strength. He required a wheelchair, and his occupational therapist taught him adaptive strategies to perform everyday tasks. In speech, it was all about learning to use his voice again and eat the foods he once enjoyed before his stroke.
“We really enjoyed going out to eat with friends before, so eating solid food again was a huge deal for us,” Paula said. “When he got here, he was not eating, but he was eating by mouth when we left.”
Returning to Their Life and Pastimes
It’s been almost a year since Jim left Encompass Health. Though he still has a long way to go in his recovery, he is getting back to many of the activities that mattered most to him prior to his hospitalization.
Before discharging from Encompass Health, his case manager connected them with resources within their community to continue his recovery and live life to his fullest. The couple now frequently attends the stroke support group at Encompass Health, which is where he was able to get back to one of his favorite pastimes.
Prior to his stroke, Jim loved playing golf. He was certain he’d never play again, but at the support group, he was introduced to an adaptive sports organization in the area. He is now back on the golf course, only a little differently than before – he now knows how to hit balls sitting in his wheelchair.
He is also walking some, another task his family didn’t think he’d be able to do, and to Paula’s delight, they are back to dining out with friends. Jim is on a regular diet as well, and much to his delight, he’s even eating chili-cheese hot dogs again.
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