Christus Spohn Rehabilitiation Center


About the Facility

CMS Certification Number (CCN)
45T046
Ownership Type
Non-profit
CMS Region
Dallas
Certification Date
Address
600 Elizabeth St.
Phone Number
(361) 881-3429

Facility Medical Condition Statistics

All other conditions
89
Brain disease or condition (non-traumatic)
23
Brain injury (traumatic)
14
Hip or femur fracture
38
Hip or knee replacement, amputation or other bone or joint condition
59
Nervous system disorder (excluding stroke)
Data not available for this reporting period.
Spinal cord disease or condition (non-traumatic)
11
Spinal cord injury (traumatic)
-
Stroke
72

Facility Quality of Patient Care Measures

Catheter-associated urinary tract infections (CAUTI)
Standardized infection ratio (SIR) 95% confidence interval - lower limit
0.048
SIR 95% confidence interval - upper limit
4.693
Comparative performance category
No Different than the National Benchmark
Catheter days
729
Predicted number of infections (B)
1.051
Number of infections reported (A)
1
SIR (A/B)
0.951
Percentage of patients whose functional abilities were assessed and functional goals were included in their treatment plan
Numerator
310
Denominator
310
Facility rate
100.0
Change in patients ability to care for themselves
Average risk-adjusted change score
10.5
Denominator
268
Average observed change score
10.4
Change in patients ability to move around
Average risk-adjusted change score
30.8
Denominator
268
Average observed change score
32.6
Percentage of patients who are at or above an expected ability to care for themselves at discharge
Numerator
128
Denominator
268
Facility rate
47.8
Percentage of patients who are at or above an expected ability to move around at discharge
Numerator
156
Denominator
268
Facility rate
58.2
Percentage of IRF patients who experience one or more falls with major injury during their IRF stay
Numerator
0
Denominator
310
Facility rate
0.0
Clostridium difficile Infection (CDI)
Standardized infection ratio (SIR) 95% confidence interval - lower limit
Not Available
SIR 95% confidence interval - upper limit
1.057
Comparative performance category
No Different than the National Benchmark
Patient days
6,515
Predicted number of infections (B)
2.834
Number of infections reported (A)
0
SIR (A/B)
0.000
Percentage of healthcare personnel who got a flu shot for the current season
Number of health care workers vaccinated
27
Number of health care workers
29
Rate of flu vaccination
93.1
Rate of potentially preventable hospital readmissions 30 days after discharge from an IRF
Number of potentially preventable readmissions following discharge
19
Number of eligible stays
316
Unadjusted potentially preventable readmission rate
6.01
Risk-standardized potentially preventable readmission rate (RSRR)
7.91
Lower limit of the 95% confidence interval on the RSRR
6.37
Upper limit of the 95% confidence interval on the RSRR
9.95
Comparative performance category
No Different than the National Rate
Rate of potentially preventable hospital readmissions during the IRF stay
Number of potentially preventable readmissions
28
Number of eligible stays
362
Unadjusted potentially preventable readmission rate
7.73
Risk-standardized potentially preventable readmission rate (RSRR)
6.84
Lower limit of the 95% confidence interval on the RSRR
5.38
Upper limit of the 95% confidence interval on the RSRR
9.09
Comparative performance category
Worse than the National Rate
Rate of successful return to home or community from an IRF
Observed number of discharges to community (DTC)
175
Number of eligible stays
281
Observed discharge to community rate
62.28
Risk-standardized discharge to community rate
62.63
Lower limit of the 95% confidence interval on the risk-standardized discharge to community rate
57.33
Upper limit of the 95% confidence interval on the risk-standardized discharge to community rate
67.08
Comparative performance category
No Different than the National Rate
Medicare Spending Per Beneficiary (MSPB) for patients in IRFs
MSPB score
1.04
Number of eligible episodes
315
Percentage of patients whose medications were reviewed and who received follow-up care when medication issues were identified
Numerator
300
Denominator
310
Facility rate
96.8
Percentage of patients with pressure ulcers/pressure injuries that are new or worsened
Numerator
7
Denominator
309
Facility observed rate
2.3
Facility risk-adjusted rate
2.4
Percentage of IRF healthcare personnel who completed COVID-19 primary vaccination series
Number of health care workers vaccinated
67
Number of health care workers
84
Rate of COVID-19 vaccination
79.8