Tvrh Rehabilitation Hospital


About the Facility

CMS Certification Number (CCN)
10T290
Ownership Type
Non-profit
CMS Region
Atlanta
Certification Date
Address
1451 El Camino Real
Phone Number
(352) 751-8593

Facility Medical Condition Statistics

All other conditions
163
Brain disease or condition (non-traumatic)
21
Brain injury (traumatic)
15
Hip or femur fracture
55
Hip or knee replacement, amputation or other bone or joint condition
89
Nervous system disorder (excluding stroke)
24
Spinal cord disease or condition (non-traumatic)
15
Spinal cord injury (traumatic)
Data not available for this reporting period.
Stroke
111

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
Not Available
Comparative performance category
Not Available
Catheter days
508
Predicted number of infections (B)
0.966
Number of infections reported (A)
0
SIR (A/B)
Not Available
Percentage of patients whose functional abilities were assessed and functional goals were included in their treatment plan
Numerator
489
Denominator
489
Facility rate
100.0
Change in patients ability to care for themselves
Average risk-adjusted change score
11.8
Denominator
428
Average observed change score
10.3
Change in patients ability to move around
Average risk-adjusted change score
29.7
Denominator
428
Average observed change score
29.5
Percentage of patients who are at or above an expected ability to care for themselves at discharge
Numerator
235
Denominator
428
Facility rate
54.9
Percentage of patients who are at or above an expected ability to move around at discharge
Numerator
236
Denominator
428
Facility rate
55.1
Percentage of IRF patients who experience one or more falls with major injury during their IRF stay
Numerator
0
Denominator
489
Facility rate
0.0
Clostridium difficile Infection (CDI)
Standardized infection ratio (SIR) 95% confidence interval - lower limit
0.019
SIR 95% confidence interval - upper limit
1.896
Comparative performance category
No Different than the National Benchmark
Patient days
6,342
Predicted number of infections (B)
2.601
Number of infections reported (A)
1
SIR (A/B)
0.384
Percentage of healthcare personnel who got a flu shot for the current season
Number of health care workers vaccinated
62
Number of health care workers
70
Rate of flu vaccination
88.6
Rate of potentially preventable hospital readmissions 30 days after discharge from an IRF
Number of potentially preventable readmissions following discharge
38
Number of eligible stays
464
Unadjusted potentially preventable readmission rate
8.19
Risk-standardized potentially preventable readmission rate (RSRR)
8.61
Lower limit of the 95% confidence interval on the RSRR
7.00
Upper limit of the 95% confidence interval on the RSRR
10.39
Comparative performance category
No Different than the National Rate
Rate of potentially preventable hospital readmissions during the IRF stay
Number of potentially preventable readmissions
15
Number of eligible stays
503
Unadjusted potentially preventable readmission rate
2.98
Risk-standardized potentially preventable readmission rate (RSRR)
3.90
Lower limit of the 95% confidence interval on the RSRR
2.60
Upper limit of the 95% confidence interval on the RSRR
5.27
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)
286
Number of eligible stays
397
Observed discharge to community rate
72.04
Risk-standardized discharge to community rate
69.67
Lower limit of the 95% confidence interval on the risk-standardized discharge to community rate
65.31
Upper limit of the 95% confidence interval on the risk-standardized discharge to community rate
73.23
Comparative performance category
No Different than the National Rate
Medicare Spending Per Beneficiary (MSPB) for patients in IRFs
MSPB score
0.93
Number of eligible episodes
443
Percentage of patients whose medications were reviewed and who received follow-up care when medication issues were identified
Numerator
482
Denominator
489
Facility rate
98.6
Percentage of patients with pressure ulcers/pressure injuries that are new or worsened
Numerator
0
Denominator
486
Facility observed rate
0.0
Facility risk-adjusted rate
0.0
Percentage of IRF healthcare personnel who completed COVID-19 primary vaccination series
Number of health care workers vaccinated
Not Available
Number of health care workers
Not Available
Rate of COVID-19 vaccination
Not Available