Comprehensive Inpatient Rehabilitation Unit (CIRU)
About the CIRU
Our Comprehensive Inpatient Rehabilitation Unit is accredited by the Commission on the Accreditation of Rehabilitation Facilities (CARF) and is located on the sixth floor of Western Maryland Regional Medical Center, where it provides rehabilitation services 24-hours per day, 7 days per week. The unit consists of 13 private patient rooms, a bright dining room with views of the mountains for eating meals, a spacious therapy gym, and a transitional apartment for practicing the tasks and skills needed to succeed in life after rehab. You can wear your own clothes from home and receive approximately 3 hours of therapy daily, 6 days per week. Additional services provided are medical care, rehabilitative nursing, neuropsychology and supportive psychotherapy, nutritional consultation and respiratory therapy. Because the CIRU is located within the hospital, you have access to all the services provided by the hospital, including emergency services, if the need should arise.
Our WMHS CIRU inpatient program is dedicated to providing comprehensive rehabilitative services for our patients with physical, functional thinking, swallowing and/or communication impairments. Through a team approach, we focus on providing sound rehabilitative therapy to affect positive change in functional ability, independence, and self-reliance across a variety of environments, while protecting and promoting the rights of the persons served.
Our team is committed to helping improve your best level of physical, educational, and psychosocial skills necessary for your return to your prior level of functioning.
Our CIRU uses an interdisciplinary team approach to care. Led by physicians trained in rehabilitative medicine, the team includes:
- The Client/Patient – At the center of the individualized rehabilitation approach.
- The Rehab Physician – Oversees and directs your medical care and rehabilitation treatment plan.
- Nursing – Performs ongoing assessments and coordinates care, provides medication management, as well as 24-hour reinforcement of therapy goals, and training for bowel and bladder management.
- Physical Therapy – Evaluates and treats your ability and needs for lower body strength, balance, coordination, and cardiopulmonary functioning to improve mobility and reduce pain.
- Occupational Therapy – Restores your ability to care for yourself and maximizes your functional independence in order to return to your previous level of self-care.
- Speech Therapy – Evaluates and treats swallowing, speech, language, and cognitive abilities.
- Neuropsychology – Evaluates cognitive and behavioral functioning related to your health status.
- Social Worker – Integrates you and your family’s social needs into the plan of care and coordinates discharge planning activities, including community referrals, support services, equipment, etc.
- Dietician – Evaluates your diet and nutritional needs and makes appropriate recommendations.
- Additional Services – Respiratory, laboratory, radiology, prosthetic/orthotic consults, pastoral care, and pet therapy, to name a few.
Our treatment team works together with you and your family to develop an individualized plan of rehabilitation care and then guides you through a practical and personal process to maximize functional independence.
Admission to the CIRU is elective and is based on criteria that help to ensure that the services are the most appropriate for each individual we serve.
- Be 18 years of age or older
- Have significant impairment that requires 24-hour rehabilitation medical and nursing care
- Require an intensive, interdisciplinary program that includes two or more therapies (physical, occupational, or speech therapy)
- Be willing and able to participate in about 3 hours of therapy each day or about 15 hours a week
- Be medically stable with no ongoing medical problems that would inhibit participation in an intensive physical rehabilitation program
- Have potential for improvement as a result of participation in an inpatient rehabilitation program
- Have a family member, caregiver or partner’s support if necessary to accomplish the highest level of functional outcome
- Consideration for patients with spinal cord dysfunction, whether traumatic or non-traumatic, will be reviewed on a case-by-case basis as long as the patient is not on ventilator support and the injury is at one of the following levels: sacral, lumbar, thoracic, or cervical (C6 or C7)
- Patients with an acquired brain injury will be considered if they possess the following characteristics: behavior is appropriate in a familiar setting, ability to perform daily routines automatically, shows carry-over for new learning, initiates social interactions (although judgment may remain impaired), and presents on the Rancho Los Amigos Scale at the level of 7 or higher
Rancho Los Amigos Levels of Cognitive Functioning
- Level 1: No response, the person appears to be in a deep sleep
- Level 2: Generalized response, the person reacts inconsistently, not directly in response to stimuli
- Level 3: Localized response, reacts inconsistently, directly to stimuli
- Level 4: Confused/Agitated, the person is extremely confused, agitated
- Level 5: Confused-Inappropriate/Non-Agitated, the person is confused and responds inaccurately to commands
- Level 6: Confused-Appropriate, the person is confused, responds accurately to commands
- Level 7: Automatic-Appropriate, the person goes through daily routine with minimal confusion
- Level 8: Purposeful-Appropriate, the person goes through daily routine with minimal confusion
- Level 9: Purposeful-Appropriate, the person has a functioning memory, responsive to the environment, may display depression
- Level 10: Purposeful-Appropriate/Modified Independent, go through the daily routine but may require more time or compensatory strategies, periodic depression may occur
The CIRU Understands Your Needs
The rehabilitation process can at times feel long and frustrating; therefore, your family/caregiver/partner is encouraged to participate in the treatment process. Our staff will provide you and your support system with caregiver training, home management skills and the ability to continue the rehabilitation process after transitioning to your highest level of discharge potential.
CIRU Accreditations and Feedback
The CIRU is accredited by the following agencies:
- Commission on the Accreditation of Rehabilitation Facilities (CARF) – Comprehensive Integrated Inpatient Rehabilitation Program and Stroke Specialty Program.
- Joint Commission on the Accreditation of Healthcare Organizations (JCAHO)
In our most recent Patient Satisfaction Report from the HealthStream Research Company, our patients ranked our unit in the 94th percentile for overall rating. The top percentile box attributes were in the areas of an overall rating of the therapist, clear communication and careful listening by the therapist, explanation of new medications, coordination of care/services, and timely response to call buttons.
(January 1, 2017 – December 31, 2017)
- 287 Patients Served
- Average age: 75 years
- Average number of days in CIRU: 11 days
- Where our patients went:
- 77% returned to their homes
- 12% were admitted or returned to a long-term care facility
- 10% were admitted to an acute care facility (hospital)
Patients admitted to the CIRU have a significant disability that restricts their ability to function independently. The more common causes of impairment for the patients this year were:
- Orthopedic related, such as hip fractures, etc.: 38 patients (13%)
- Stroke: 78 patients (27%)
- Spinal cord injury: 24 patients (8%)
- Neurological: 23 patients (8%)
- Cardiac: 16 patients (6%)
The program has been expanded to promote a well-rounded focus on health and wellness for all of our patients after leaving the rehabilitation program.
Please call our Rehab Nurse Liaison Specialist at 240-964-6132 to clarify any question of client eligibility or to begin the referral process.
CIRU main unit number: 240-964-6000
CIRU fax number: 240-964-6005
Hours of Operation
Open 24 hours a day