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Client Situation: A rural Critical-Access Hospital could not find proper staff for their rehabilitation department. This was causing significant loss of revenue and profit to the department, and the hospital as a whole.

Solution: Immediately staff the rehab department with qualified personnel, and create a management contract that will create profits for the rehab department, and increase profit margins for the hospital as a whole.

In November 2004 our director of business development made a sales call to a rural hospital in Indiana. The Director of Clinical Services told him if he could get a therapist there the next day, they would discuss a management contract. This hospital had an opening for a physical therapist for 9 months. Ron Cram, PT, the president of the management company, personally covered the Directorís request the next business day, and immediately started negotiating a management contract.

As a Critical Access Hospital, the administration desired to keep residents of the community at their hospital, instead of transferring them to larger metropolitan hospitals. However, given the staffing shortage for therapists in rural communities, this hospital was unable to adequately care for their patients, and had to send the more critical patients to other hospitals. This situation also made nurse staffing more difficult as full-time nurses had repeatedly had their hours cut - because of the fluctuations in patient volumes at the hospital.

With our enhanced recruiting resources, attractive benefits package, and bonus program, we were able to recruit 3 Physical Therapists to the community. With permanent therapists in place, we were able to start utilizing the hospitalís swing-beds, and keep patients at the hospital for 7-10 days after their acute stay to receive the necessary rehab before returning home. The benefits were numerous.

The patient was able to stay in their local hospital - instead of being transferred to a nursing home or another hospital, the families were appreciative of the care being delivered close to home (which allowed them to frequently and easily visit their loved ones), nursing hours stabilized, and census improved without the volatility they experienced in the past.

We also found un-utilized space in the hospital, and moved the off-site clinic back into the hospital. This increased the size of the rehab department - which reduced overlapping therapy staff, and increased the hospitalís space allocation and overhead push in regard to rehabilitation therapy.

We also increased out-patient volume through community outreach to local employers for workerís compensation treatment, and to the local high schoolsí athletic training program for treatment of students. This improved the payer-mix by adding these private insurances, and attracting younger patients to the hospital.

The first year net result was an increase in revenue of 95% and contribution to margin of over 400%!