Community Living Center-Comprehensive Integrated Inpatient Rehabilitation Program (CIIRP)/Short-Term Acute Rehabilitation
The Acute Rehabilitation Program on CLC provides a team approach to the care of Veterans with complex conditions. Physicians, therapists, nurses, and other professionals work with Veterans who require intensive rehabilitation to reach their highest level of function and independence.
Based on the individual medical and rehabilitation assessment/needs of the veteran, both pre-admission and during admission, services provided on CIIRP include an interdisciplinary team led by a board-certified Physical Medicine and Rehabilitation Physician.
Inpatient rehabilitative services are available for eligible Veterans 17 years of age or older who are medically stable and require 24-hour rehabilitation nursing care. Veterans treated on the CIIRP floor may have any of the following impairments: stroke, other neurological disorders, limb amputations, arthritis, other orthopedic conditions, and other disabling impairments.
Staff members of the CIIRP team include dedicated specialists in the following areas: Physical Therapy, Occupational Therapy, Speech Language Pathology, Recreation Therapy, Neuropsychology, Social Work, Rehabilitation Nursing, and Registered Dieticians. Personnel in each area have achieved specialized education and certification in their specific discipline.
Intensity and frequency of services provided are based on the individual needs of the veteran. Typically, Physical Therapy and Occupational Therapy is provided for a minimum of one hour, five times per week. The remainder of services are delivered on an as needed basis, depending on individualized patient assessment and patient goals.
Education of the veteran and family/support system takes place throughout the admission, individualized to the veteran’s needs and medical conditions. On site access to comprehensive medical and surgical services is available. Discharge planning begins from the time of admission and is targeted to the veteran and family/support system goals.
Scope of Service
CIIRP is a 24/7 program and provided 2-3 hours of therapies Monday-Friday. Persons served receives 1-2 hours of physical therapy, 1 hour of occupational therapy on weekdays. Other therapies provided within the 2-3 hours of therapies may include recreation therapy and speech/language therapy.
We provide rehabilitation services to Veterans with disabling conditions, including:
- Hip and knee replacements
- Spine surgery
- Bone fractures
Services not currently provided are as follows:
- Ventilator-dependent care
- Spinal cord injury
- Traumatic brain injury
- Medical or assistive equipment that is not medically necessary
Entry and Exit Criteria
The following are the criteria for admission:
- Have mobility, self-care and communication problems that need at least two types of therapy such as physical and speech therapy, pain management, wound care, and/or cognitive rehab
- Willing and able to do an average of 2-3 hours of therapy per day
- Have reachable goals
- Medically stable for at least 24 hours
- The discharge will be to where you were living before the hospitalization or to other living options that have the needed support systems.
Below are the discharge criteria:
- Veteran has achieved treatment goals.
- Veteran is ready to move to a higher or lower level of care than what we offer.
- Veteran no longer making progress toward goals and no new goals have been identified.
- Veteran requests discharge from the program.
- Veteran has not been participating in the program.
- Veteran is unable to actively and safely participate in the program.
Amputee Specialty Program
About the Amputee Specialty Program
The Amputation Specialty Program (ASP) is accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF). It provides intensive inpatient rehabilitation services to Veterans with limb loss.
The program addresses physical, psychological, and medical problems to maximize each Veteran’s quality of life and a safe return to home. The ASP is located within the CIIRP unit in the Community Living Center (CLC) at the Jennifer Moreno Medical Center.
Maximize the health, functional independence, and quality of life for Veterans with disabilities through excellence in clinical care, education, and research.
The rehabilitation team includes:
- Amputee Rehabilitation Coordinator
- Social Worker
- Physical Therapist
- Recreation Therapist
- Occupational Therapist
- Speech Language Pathologist
- Peer Support
- Chaplain, Dietitian and others based on need
Who is eligible for ASP
Eligible Veterans are assessed through the following criteria:
- Must be medically stable
- Must be able to participate in therapy 3 hours a day, five days a week
- Must need help with two or more therapies(PT/OT/ST)
- Must be alert and able to follow instructions
- Must be motivated, capable, and willing to participate in therapies
- Should be able to improve function or achieve independence
- Should be able to be discharged outside of the institutional setting.
Items to Bring to ASP Inpatient Rehab
- Grooming items for personal care
- Wheelchair, cushion, leg
- Rests, stump support, etc
- Easy to pull-on clothing, laundry detergent (washer/dryer available)
- Assistive Devices (i.e., walker, cane, crutches)
- Underwear, socks
- Stump shrinker, liners
- Sturdy walking shoes
Veteran Satisfaction Last Fiscal Year
CIIRP Outcomes Last Fiscal Year
We collect information about our rehabilitation program regularly and share it with you. The following information is from FY2022 (October 1, 2022-September 30, 2023).
How many and what kind of persons served have been seen in this program?
- 8 persons served have been seen during this period. (1 woman, 7 men)
- 3 were admitted from the acute care units of SD VA Medical Center, 3 from outside the hospital,
- 2 were admitted from home for prosthetic gait training.
The average age was 66 years.
What are the most common diagnoses?
- 2 persons served had polytrauma.
- 2 persons served had an orthopedic diagnosis.
- 2 persons served had a stroke.
- 2 persons served had an amputation.
How much better do persons serve to get in this program?
- Persons served are generally transferred on average seven days from acute care to rehabilitation (CIIRP).
- The length of stay in rehabilitation averaged 11 days for this period.
- Polytrauma rehabilitation persons served had an average weekly Functional Independence Measure (FIM) gain of 16.75
- Stroke rehabilitation persons served had an average weekly FIM gain of 4.1
- Orthopedic rehabilitation persons served had an average weekly FIM gain of 14.4
- The amputee prosthetic gait training person served had an average week FIM gain of 12.3
- Average number of treatment hours per day: 2.85
- Unplanned transfers to acute medical facilities: 0
Most persons we served surveyed three months after being discharged from CIIRP continued to do their own care. This was due to excellent discharge instructions, home programs, and follow-up in the Outpatient Rehabilitation Clinic.
Data from other VA rehabilitation programs and National rehabilitation programs were not available for comparison this past fiscal year.
How satisfied have others been with the care in this program?
- Using a satisfaction scale ranging from 1 (lowest) to 4 (highest), the persons we served surveyed reported satisfactory and favorable responses, averaging 4 out of 4.
CLC and CIIRP Interdisciplinary Team and Patient Advocates monitor complaints from persons served.
Will I be able to go home at discharge?
- 100% of our persons served during this period went home.