April 16, 2014

Treatment Centers

There are a number of resources available to the families and patients of a Traumatic Brain Injury (TBI).  This section helps you select the right kind of TBI treatment center for your needs.  Click on the link to locate a treatment center in your state.

Acute Hospitals

Acute hospitals provide emergency, neurosurgical and medical stabilization.  Acute hospitals provide early treatment, stabilize complications and minimize neurological and related complications after TBI.

Trauma centers provide an expert, coordinated team approach to traumatic brain injury care.  If the patient is taken to a hospital that is not a trauma center, ask for the nearest trauma center and request a possible transfer.  Also, if the patient is not in an acute rehab unit within the acute hospital, request a transfer once the patient is medically stable.

The typical length of stay in an acute hospital varies based on the presence and duration of a coma, the need for neurosurgery, and multiple traumas.

The TBI patient may receive therapies in this setting, but if therapies are not received, request and discuss therapy options with the neurologist and neurosurgeon.  Early intervention makes a difference in functional outcome.  Physical, occupational, speech and psychology therapy may be necessary.

Rehabilitation Units and Hospitals

Once the TBI patients is medically stable, a referral may be made to the acute rehab unit within the hospital setting, or to a freestanding acute rehabilitation hospital.

We suggest that the TBI  patient receive rehabilitationcare in a setting where the team, physicians, nurses, therapists and staff have expertise in the management of traumatic brain injury.

The commission on accreditation of rehabilitationfacilities (CARF) provides consumer information on accreditation and standard services for traumatic brain injuries.  Not all rehab units, hospitals or facilities seek CARF accreditation, but these standards for providers can be used as a score card when selecting the best setting for acute rehabilitation.

Consult your insurer as early as possible about level of services for rehabilitationcare that are covered by your policy, as well as anticipated/projected length of stay.

When selecting a treatment center, tour a few different units, hospitals or centers, if possible.  Ask each treatment center for quality outcome data on TBI program.

If the TBI patient is unable to participate in therapy for at least up to three hours daily, ask if the program will find a way to increase tolerance and participation ability.

If the TBI patient is being recommended for transfer to a nursing home or other “rehab” center, ask for an estimate about the anticipated length of stay, as well as the possibility for transfer to an acute rehab program once therapy toleration improves.

If the patient has a mild brain injury and is discharged from the emergency room, ask for a referral to an outpatient brain injury program for neuropsychology evaluation and treatment.  Be aware of the signs of mild TBI.  Click for more information about Mild TBI symptoms.

Post Acute Rehabilitation Brain Injury Programs

After completion of an acute rehab program, the individual with a brain injury may

  • Return home to the community with home care
  • Be referred to a community-based brain injury program in a residential apartment setting
  • Return home with a referral to an outpatient program, preferably one that specializes in brain injury services for ongoing outpatient therapy, vocational services, day programs or a combination of these services
  • Be placed in a skilled nursing facility, or sub acute setting, as requested by the family.  We recommend a setting that has experience managing traumatic brain injury medical and behavioral problems.
  • Choose intermittent respite care.  This case may also be available in community-based brain injury programs, as well as skilled facilities.
  • Be recommendedto an assisted-living settings.  Be sure to search for settings with expertise in brain injury.  As an example, a typical Alzheimer unit is not appropriate for a TBI patient.

Some TBI patients may find that vocational rehabilitation programs with TBI expertise may also be a valuable resource when returning to both noncompetitive and competitive employment. State- funded offices of vocational rehabilitationservices may also be helpful in obtaining vocational evaluation and treatment.

Driver education and evaluation services may be available to TBI patients at local rehabilitation hospitals.

Other Resources To Contact

  • State brain injury associations (such as biapa.org for local head injury support groups
  • Local care giver support groups provided by your area rehab hospitals
  • Advocacy agencies
  • Your state’s workers’ compensation agency for additional resources for case management, vocational services, legal services and advocacy groups
  • CARF (commission for the accreditation of rehab facilities) for other resources
  • Your state’s medical assistance waiver programs for possible financial resources and funding for program placement
  • Your state’s head injury funding programs for eligibility for program evaluation and placement

For more information on other resource options: