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New York State Certified Brain Injury Rehabilitation Program

There are two distinct levels of care. The subacute program is certified by the New York State Department of Health as a specialized inpatient rehabilitation program for brain injured individuals. The long term extended program provides continued brain injury rehabilitation services in line with federal and state rules and regulations for long term care facilities.

The subacute brain injury rehabilitation program provides a link between acute hospital-based TBI treatment and community living. It is a 40-bed intensive rehab, cognitive-focused interdisciplinary program. The length of stay in this level of care ranges from 3-12 months. All residents admitted to the program receive 3 hours a day of restorative Physical Therapy (PT), Occupational Therapy (OT), Speech and Language Therapy (ST), and Cognitive rehabilitation as well as ongoing neuropsychological, behavior management and psychological services. For individuals with disorders of consciousness admitted to this program, individualized structured sensory stimulation is provided by nursing as well as incorporated into treatment by OT, PT and ST. In addition, daily structured therapeutic recreation programs are provided for all residents, as well as case management and discharge planning services.

A Physiatrist who specializes in TBI serves as the Medical Director, a Master’s level licensed clinical social worker acts as program coordinator, overseeing the day to day operations of the program, and a Masters level OT/R functions as the Director of Rehabilitation. The Director of Neuropsychological Rehabilitation, a Ph.D. level Clinical Neuropsychologist, supervises and directs all aspects of the Cognitive Rehabilitation program, neuropsychological and psychological services, and is also responsible for overseeing and coordinating inter-disciplinary treatment planning, as well as providing ongoing education and training to all of the rehabilitation staff. All rehabilitation staff are highly trained and have a minimum of Bachelor’s level education, with many possessing Masters degrees or Doctorates in their respective fields. PTCC therapies are provided in gyms, classrooms, mock home environments as well as directly in the community. Treatment planning is highly individualized, performed collaboratively between disciplines, and integrates both the residents’ and their families’ goals. Furthermore, all of the therapy disciplines integrate the use of evidence-based cognitive remediation strategies into treatment (Cicerone et al, 2011, Cicerone et al, 2005, Cicerone et al., 2000). The subacute program places a strong emphasis on skill generalization and community re-integration, with the overriding goal of maximizing residents’ functional independence regardless of their impairment level. Upon completion of their rehabilitation stay, a majority of individuals admitted to this intensive program return to living in the community with support.

Extended Brain Injury Program

The extended brain injury program is designed for individuals recovering at a slower pace, those who require ongoing coma management, supervision for safety, or continued intensive nursing and medical care. The program adopts a psychosocial model of care, focusing on rehabilitation when indicated while focusing on providing services to meet the psychosocial needs of the resident. The range, frequency and intensity of rehabilitation treatments varies at this level of care, depending on the individual’s unique needs and abilities to benefit. Therapy can be either restorative or maintenance focused and includes some combination of PT, OT, and ST, as well as psychological services. For individuals with disorders of consciousness, structured sensory stimulation programs are provided on both an individual and group basis. As with the subacute program, daily structured therapeutic recreation programs, case management and discharge planning are also provided.

Cicerone, K., Dahlberg, C., Kalmar, K., Langenbahn, D., Malec, J., Bergquist, T. et al. (2000) Evidence-based cognitive rehabilitation: Recommendations for clinical practice. Archives of Physical Medicine and Rehabilitation, 81, 1596-1615.

Cicerone, K.D., Dahlberg, M.A., Malec, J.F., Langenbahn, D.M., Felicetti, T., Kneipp, S., Ellmo, W., Kalmar, K., Giacino, J.T., Harley, J.P., Laatsch, L., Morse, P.A., & Catanese, J. (2005) Evidence-based cognitive rehabilitation: updated review of the literature from 1998 to 2002. Archives of Physical Medicine and Rehabilitation, 86, 1681-1692.

Cicerone, K.D., Langenbahn, D.M., Braden, C., Malec, J.F., Kalmar, K., Fraas, M., Felicetti, T., Laatsch, L., Harley, J.P., Bergquist, T., Azulay J., Cantor, J., & Ashman, T. (2011) Evidence-based cognitive rehabilitation: updated review of the literature from 2003 through 2008. Archives of Physical Medicine and Rehabilitation, 9, 519-530.