Encompass Health Rehab Hospital an Affiliate of Ma


About the Facility

CMS Certification Number (CCN)
103044
Ownership Type
For Profit
CMS Region
Atlanta
Certification Date
Address
5850 Se Community Dr
Phone Number
(772) 324-3500

Facility Medical Condition Statistics

All other conditions
581
Brain disease or condition (non-traumatic)
205
Brain injury (traumatic)
103
Hip or femur fracture
268
Hip or knee replacement, amputation or other bone or joint condition
398
Nervous system disorder (excluding stroke)
260
Spinal cord disease or condition (non-traumatic)
71
Spinal cord injury (traumatic)
13
Stroke
342

Facility Quality of Patient Care Measures

Catheter-associated urinary tract infections (CAUTI)
Standardized infection ratio (SIR) 95% confidence interval - lower limit
Not Available
SIR 95% confidence interval - upper limit
1.261
Comparative performance category
No Different than the National Benchmark
Catheter days
2,199
Predicted number of infections (B)
2.376
Number of infections reported (A)
0
SIR (A/B)
0.000
Percentage of patients whose functional abilities were assessed and functional goals were included in their treatment plan
Numerator
2,200
Denominator
2,200
Facility rate
100.0
Change in patients ability to care for themselves
Average risk-adjusted change score
12.8
Denominator
1,968
Average observed change score
14.0
Change in patients ability to move around
Average risk-adjusted change score
30.6
Denominator
1,968
Average observed change score
31.5
Percentage of patients who are at or above an expected ability to care for themselves at discharge
Numerator
1,210
Denominator
1,968
Facility rate
61.5
Percentage of patients who are at or above an expected ability to move around at discharge
Numerator
1,116
Denominator
1,968
Facility rate
56.7
Percentage of IRF patients who experience one or more falls with major injury during their IRF stay
Numerator
4
Denominator
2,200
Facility rate
0.2
Clostridium difficile Infection (CDI)
Standardized infection ratio (SIR) 95% confidence interval - lower limit
0.563
SIR 95% confidence interval - upper limit
1.975
Comparative performance category
No Different than the National Benchmark
Patient days
28,265
Predicted number of infections (B)
9.024
Number of infections reported (A)
10
SIR (A/B)
1.108
Percentage of healthcare personnel who got a flu shot for the current season
Number of health care workers vaccinated
314
Number of health care workers
457
Rate of flu vaccination
68.7
Rate of potentially preventable hospital readmissions 30 days after discharge from an IRF
Number of potentially preventable readmissions following discharge
300
Number of eligible stays
2,555
Unadjusted potentially preventable readmission rate
11.74
Risk-standardized potentially preventable readmission rate (RSRR)
11.46
Lower limit of the 95% confidence interval on the RSRR
10.35
Upper limit of the 95% confidence interval on the RSRR
12.74
Comparative performance category
Worse than the National Rate
Rate of potentially preventable hospital readmissions during the IRF stay
Number of potentially preventable readmissions
138
Number of eligible stays
2,767
Unadjusted potentially preventable readmission rate
4.99
Risk-standardized potentially preventable readmission rate (RSRR)
5.23
Lower limit of the 95% confidence interval on the RSRR
4.37
Upper limit of the 95% confidence interval on the RSRR
6.33
Comparative performance category
No Different than the National Rate
Rate of successful return to home or community from an IRF
Observed number of discharges to community (DTC)
1,541
Number of eligible stays
2,224
Observed discharge to community rate
69.29
Risk-standardized discharge to community rate
69.59
Lower limit of the 95% confidence interval on the risk-standardized discharge to community rate
67.62
Upper limit of the 95% confidence interval on the risk-standardized discharge to community rate
71.39
Comparative performance category
Better than the National Rate
Medicare Spending Per Beneficiary (MSPB) for patients in IRFs
MSPB score
1.02
Number of eligible episodes
2,646
Percentage of patients whose medications were reviewed and who received follow-up care when medication issues were identified
Numerator
2,197
Denominator
2,200
Facility rate
99.9
Percentage of patients with pressure ulcers/pressure injuries that are new or worsened
Numerator
13
Denominator
2,199
Facility observed rate
0.6
Facility risk-adjusted rate
0.6
Percentage of IRF healthcare personnel who completed COVID-19 primary vaccination series
Number of health care workers vaccinated
296
Number of health care workers
363
Rate of COVID-19 vaccination
81.5