Brain Injury Outcomes

Who we treat

Each year, we provide inpatient treatment for 21 adolescents with brain injuries.

Injury types

• Traumatic brain injury (TBI): 76.2%
• Other brain injuries: 23.8%

Patient ages

12-17 years old (average age is 16)

Patient genders

• Male: 76%
• Female: 24%

Admission and length of stay

• Average length of stay: 42 days
• Time to admission: On average, adolescent patients begin inpatient rehabilitation 31 days after injury

Therapy and rehabilitation

Our patients receive extensive therapy, typically ranging from 3-5 hours daily. This includes physical, occupational, and speech therapy, tailored to each patient’s needs.

Patient satisfaction

When asked about the likelihood of their recommending Shepherd Center, patients or their caregivers rated Shepherd Center a 100 out of 100.

Where our adolescents go after discharge

• Community: 100%
• Unplanned transfers: 0%

Personal goals and progress

100% of adolescent inpatients reach or exceed their expected personal goals during their rehabilitation. Patients work with their therapy team to come up with goals. These goals may focus on physical or mental abilities that patients want to return to doing, or it can be something new. A few examples include:

• “I want to return to playings sports.”
• “I want to be able to play video games with my friends.”
• “I want to be able to make my own meals.”

Who we treat

Each year, we provide inpatient treatment for 271 adults with brain injuries.

Injury types

• Traumatic brain injury (TBI): 72.7%
• Non-traumatic brain injury: 16.6%
• Other brain injuries: 10.7%

Patient ages

The average adult inpatient with a brain injury at Shepherd Center is 38 years old. The age breakdown includes:

• 18-25: 30%
• 26-35: 23%
• 36-45: 17%
• 46-55: 14%
• 56-65: 11%
• 65+: 6%

Patient genders

• Male: 74%
• Female: 26%

Admission and length of stay

• Average length of stay: 48 days
• Time to admission: On average, adult patients begin inpatient rehabilitation 35 days after injury

Therapy and rehabilitation

Our patients receive extensive therapy, typically ranging from 3-5 hours daily. This includes physical, occupational, and speech therapy, tailored to each patient’s needs.

Patient satisfaction

When asked about the likelihood of their recommending Shepherd Center, patients or their caregivers rated Shepherd Center a 95 out of 100.

Where our patients go after discharge

• Community: 92.4%
• Acute care: 4%
• Long-term care: 1.8%
• Other Rehabilitation: 1.45%
• Hospice: 0.36%
• Unplanned transfers: 1.8% of patients have an unplanned transfer to an acute care facility

Self-care goals

69% of adult inpatients achieve or exceed their anticipated value of self-care upon discharge from Shepherd Center, compared to 66% nationally.

Mobility goals

70% of adult inpatients achieve or exceed their anticipated value of mobility upon discharge from Shepherd Center, compared to 65% nationally.

Mobility scores tell us how much help a patient needs with activities like sitting, standing, walking, using a wheelchair, or going up and down stairs. A physical therapist helps patients get better at doing these activities on their own. If the scores go up from when the patient first came in to when they left, it means the patient got better at doing these activities independently.

Personal goals and progress

93% of adult inpatients with brain injuries reach or exceed their expected personal goals during their rehabilitation. Patients work with their therapy team to come up with goals. These goals may focus on physical or mental abilities that patients want to return to doing, or it can be something new. A few examples include:

• “I want to be able to cook a meal with my grandchildren.”
• “I can manage my household finances.”
• “I want to be able to feed myself.”

Who we treat

Each year, we provide inpatient treatment for 42 individuals with disorders of consciousness.

Patient ages

The average inpatient with disorders of consciousness at Shepherd Center is 37 years old. The age breakdown includes:

• Under 18: 5%
• 18-25: 36%
• 26-35: 7%
• 36-45: 21%
• 46-55: 10%
• 56-65: 19%
• 65+: 2%

Patient genders

• Male: 81%
• Female: 19%

Admission and length of stay

• Patients who emerge from a minimally conscious or unresponsive wakefulness state and advance to a rehabilitation level of care typically spend 85 days at Shepherd Center and 51 days in rehabilitation.
• Patients who are discharged in a minimally conscious or unresponsive wakefulness state typically spend 77 days at Shepherd Center.

Cognitive and behavioral patterns

• 57% of the patient population emerges from a minimally conscious or unresponsive wakefulness and advances to a rehabilitation level of care (Rancho Los Amigos Cognitive Recovery Scale, Level 4 or above).
• 38% of the patient population discharges from Shepherd Center in a minimally conscious or unresponsive wakefulness state.
• 5% of the patient population expires while at Shepherd Center, often as a result of the family choosing to withdraw life-sustaining treatment.

Patient satisfaction

When asked about the likelihood of their recommending Shepherd Center, patients or their caregivers rated Shepherd Center 95 out of 100.

Where our patients go after discharge

Patients with disorders of consciousness at Shepherd Center who emerge from a minimally conscious or unresponsive wakefulness state and advance to a rehabilitation level of care typically transition to:

• Home: 88%
• Long-term care: 8%
• Hospice: 4%

Patients with disorders of consciousness at Shepherd Center who are discharged in a minimally conscious or unresponsive wakefulness state typically transition to:

• Home: 69%
• Acute care: 13%
• Long-term care: 13%
• Hospice: 6%

Neurobehavioral condition

Shepherd Center uses the Coma Recover Scale-Revise (CRS-R) to measure behavioral responses to stimuli. The higher the score, the higher the level of consciousness.

Patients with disorders of consciousness who emerge from a minimally conscious or unresponsive wakefulness state and advance to a rehabilitation level of care have the following CRS-R measurements at admission and discharge:

• Admission: 9
• Discharge: 18

Patients with disorders of consciousness who are discharged in a minimally conscious or unresponsive wakefulness state have the following CRS-R measurements at admission and discharge:

• Admission: 5
• Discharge: 8

The CRS-R test helps medical professionals understand how the brain is working for people who are asleep or can’t speak. The test has 23 parts and yields a total score of 0-23. It looks at how patients react to sounds, what they see, movement, and if they can follow basic instructions or speak. The score shows if consciousness is improving.

Who we treat

Each year, we provide outpatient treatment for 15 adolescents with brain injuries.

Type of outpatient visits

• Day program: 67 visits
• Outpatient program: 38 visits

Patient ages

12-17 years old (average age is 17)

Patient genders

• Male: 80%
• Female: 20%

Patient satisfaction

When asked about the likelihood of their recommending Shepherd Center, patients or their caregivers rated Shepherd Center a 100 out of 100.

Improvements in abilities, adjustments, and participation during rehabilitation

At Shepherd Center, we track significant improvements in your abilities, adjustments to your daily life, and participation in activities while under our care. These improvements are measured using the Mayo-Portland Adaptability Inventory, which evaluates challenges to community reintegration and social and physical environments. Assessments are made at admission and again at discharge. Lower score indicate greater integration.

Note: Research tells us that a 5-point charge or higher from admission to discharge on the total score is a meaningful improvement.

Ability

• Admission score: 48 (mild to moderate impairment)
• Discharge score: 40 (mild impairment)
• Improvement: Patients improved their ability score by an average of 8 points from admission to discharge

Adjustment

• Admission score: 43 (mild to moderate impairment)
• Discharge score: 38 (mild impairment)
• Improvement: Patients improved their adjustment score by an average of 6 points from admission to discharge

Participation

• Admission score: 47 (mild to moderate impairment)
• Discharge score: 43 (mild to moderate impairment)
• Improvement: Patients improved their participation score by an average of 5 points from admission to discharge

Overall progress (ability, adjustment, and participation)

• Admission score: 49 (mild to moderate impairment)
• Discharge score: 41 (mild impairment)
• Improvement: Patients improved their total scores by an average of 8 points from admission to discharge

Recommended supervision after discharge

Shepherd Center uses the Supervision Rating Scale (SRS) to measure the recommended level of supervision a patient receives from caregivers upon discharge. SRS percentages for adolescent outpatients with brain injuries include:

• Can be alone for 8+ hours: 29%
• Can be alone for up to 7 hours: 11%
• Other: 60%

The category of “other” represents varying supervision levels, such as:

• Patient can be left alone for up to 1 hour: Supervision is provided to the patient overnight & part-time during waking hours. Supervising caregiver cannot work a full-time job.
• Full-time indirect supervision: Patient is never left alone. Supervising person checks in 30 minutes or less.
• Full-time direct supervision: Patient is never left alone. Supervising person checks in more than every 30 minutes.
• Physical control of exits: Patient lives in a setting in which exits are physically controlled by others, plus a supervising person is designated to provide full-time line-of-sight supervision.
• Physical restraints: The patient is in physical restraints.

Personal goals and progress

57% of adolescent outpatients reach or exceed their expected personal goals during their rehabilitation. Patients work with their therapy team to come up with goals. These goals may focus on physical or mental abilities that patients want to return to doing, or it can be something new. A few examples include:

• “I want to return to playings sports.”
• “I want to be able to play video games with my friends.”
• “I want to be able to make my own meals.”

Who we treat

Each year, we provide outpatient treatment for 346 adults with brain injuries.

Patient ages

The average adult outpatient with a brain injury at Shepherd Center is 40 years old. The age breakdown includes:

• 18-25: 26%
• 26-35: 23%
• 36-45: 13%
• 46-55: 16%
• 56-65: 13%
• 65+: 9%

Patient genders

• Male: 65%
• Female: 35%

Type of outpatient visits

• Day program: 89 visits
• Outpatient program: 33 visits

Patient satisfaction

When asked about the likelihood of their recommending Shepherd Center, patients or their caregivers rated Shepherd Center a 98 out of 100.

Improvements in abilities, adjustments, and participation during rehabilitation

At Shepherd Center, we track significant improvements in your abilities, adjustments to your daily life, and participation in activities while under our care. These improvements are measured using the Mayo-Portland Adaptability Inventory, which evaluates challenges to community reintegration and social and physical environments. Assessments are made at admission and again at discharge. Lower score indicate greater integration.

Note: Research tells us that a 5-point charge or higher from admission to discharge on the total score is a meaningful improvement.

Ability

• Admission score: 50 (mild to moderate impairment)
• Discharge score: 41 (mild impairment)
• Improvement: Patients improved their ability score by an average of 9 points from admission to discharge

Adjustment

• Admission score: 44 (mild to moderate impairment)
• Discharge score: 37 (mild impairment)
• Improvement: Patients improved their adjustment score by an average of 7 points from admission to discharge

Participation

• Admission score: 49 (mild to moderate impairment)
• Discharge score: 43 (mild to moderate impairment)
• Improvement: Patients improved their participation score by an average of 6 points from admission to discharge

Overall progress (ability, adjustment, and participation)

• Admission score: 48 (mild to moderate impairment)
• Discharge score: 39 (mild impairment)
• Improvement: Patients improved their total scores by an average of 9 points from admission to discharge

Recommended supervision after discharge

Shepherd Center uses the Supervision Rating Scale (SRS) to measure the recommended level of supervision a patient receives from caregivers upon discharge. SRS percentages for adult outpatients with brain injuries include:

• Can be alone for 8+ hours: 29%
• Can be alone for up to 7 hours: 11%
• Other: 60%

The category of “other” represents varying supervision levels, such as:

• Patient can be left alone for up to 1 hour: Supervision is provided to the patient overnight & part-time during waking hours. Supervising caregiver cannot work a full-time job.
• Full-time indirect supervision: Patient is never left alone. Supervising person checks in 30 minutes or less.
• Full-time direct supervision: Patient is never left alone. Supervising person checks in more than every 30 minutes.
• Physical control of exits: Patient lives in a setting in which exits are physically controlled by others, plus a supervising person is designated to provide full-time line-of-sight supervision.
• Physical restraints: The patient is in physical restraints.

Personal goals and progress

64% of adult outpatients reach or exceed their expected personal goals during their rehabilitation. Patients work with their therapy team to come up with goals. These goals may focus on physical or mental abilities that patients want to return to doing, or it can be something new. A few examples include:

• “I want to be able to cook a meal with my grandchildren.”
• “I can manage my household finances.”
• “I want to be able to feed myself.”

Who we treat

Each year, we provide residential treatment for 21 adults with brain injuries.

Length of stay

The average length of stay is 55 days (4-9 weeks).

Patient ages

The average adult residential patient with a brain injury at Shepherd Center is 43 years old. The age breakdown includes:

• 18-25: 19%
• 26-35: 24%
• 36-45: 10%
• 46-55: 10%
• 56-65: 33%
• 65+: 5%

Patient genders

• Male: 76%
• Female: 24%

Patient satisfaction

When asked about the likelihood of their recommending Shepherd Center, patients or their caregivers rated Shepherd Center a 88 out of 100.

Improvements in abilities, adjustments, and participation during rehabilitation

At Shepherd Center, we track significant improvements in your abilities, adjustments to your daily life, and participation in activities while under our care. These improvements are measured using the Mayo-Portland Adaptability Inventory, which evaluates challenges to community reintegration and social and physical environments. Assessments are made at admission and again at discharge. Lower score indicate greater integration.

Note: Research tells us that a 5-point charge or higher from admission to discharge on the total score is a meaningful improvement.

Ability

• Admission score: 52 (moderate to severe impairment)
• Discharge score: 44 (mild to moderate impairment)
• Improvement: Patients improved their ability score by an average of 8 points from admission to discharge

Adjustment

• Admission score: 45 (mild to moderate impairment)
• Discharge score: 38 (mild impairment)
• Improvement: Patients improved their adjustment score by an average of 7 points from admission to discharge

Participation

• Admission score: 51 (moderate to severe impairment)
• Discharge score: 46 (mild to moderate impairment)
• Improvement: Patients improved their participation score by an average of 5 points from admission to discharge

Overall progress (ability, adjustment, and participation)

• Admission score: 49 (mild to moderate impairment)
• Discharge score: 42 (mild impairment)
• Improvement: Patients improved their total scores by an average of 7 points from admission to discharge

Recommended supervision after discharge

Shepherd Center uses the Supervision Rating Scale (SRS) to measure the recommended level of supervision a patient receives from caregivers upon discharge. SRS percentages for adult resident patients with brain injuries include:

• Can be alone for 8+ hours: 29%
• Can be alone for up to 7 hours: 11%
• Other: 60%

The category of “other” represents varying supervision levels, such as:

• Patient can be left alone for up to 1 hour: Supervision is provided to the patient overnight & part-time during waking hours. Supervising caregiver cannot work a full-time job.
• Full-time indirect supervision: Patient is never left alone. Supervising person checks in 30 minutes or less.
• Full-time direct supervision: Patient is never left alone. Supervising person checks in more than every 30 minutes.
• Physical control of exits: Patient lives in a setting in which exits are physically controlled by others, plus a supervising person is designated to provide full-time line-of-sight supervision.
• Physical restraints: The patient is in physical restraints.

Personal goals and progress

65% of adult residential patients reach or exceed their expected personal goals during their rehabilitation. Patients work with their therapy team to come up with goals. These goals may focus on physical or mental abilities that patients want to return to doing, or it can be something new. A few examples include:

• “I want to be able to cook a meal with my grandchildren.”
• “I can manage my household finances.”
• “I want to be able to feed myself.”

Who we treat

Each year, we provide outpatient treatment for 69 adolescents with concussions.

Patient genders

• Female: 58%
• Male: 42%

Type of outpatient visits

• Physical therapy: 4
• Occupational therapy: 4
• Speech therapy: 3
• Psychology and neuropsychology: 2

Patient satisfaction

When asked about the likelihood of their recommending Shepherd Center, patients or their caregivers rated Shepherd Center a 100 out of 100.

Reduction in concussion symptoms

98% of adolescent outpatients experienced a reduction in the number and severity of their concussion symptoms between starting and finishing treatment.

Improvement in depression

100% of adolescent outpatients who completed psychology services experienced an improvement in their depression based on the Patient Health Questionnaire (PHQ9).

Who we treat

Each year, we provide outpatient treatment for 413 adults with concussions.

Patient ages

• 18-25: 31%
• 26-35: 16%
• 36-45: 13%
• 46-55: 16%
• 56-65: 11%
• 65+: 12%

Patient genders

• Male: 44%
• Female: 56%

Type of outpatient visits

• Physical therapy: 6
• Occupational therapy: 5
• Speech therapy: 5
• Psychology and neuropsychology: 3

Patient satisfaction

When asked about the likelihood of their recommending Shepherd Center, patients or their caregivers rated Shepherd Center a 98 out of 100.

Reduction in concussion symptoms

82% of adult outpatients experienced a reduction in the number and severity of their concussion symptoms between starting and finishing treatment.

Improvement in depression

100% of adult outpatients who completed psychology services experienced an improvement in their depression based on the Patient Health Questionnaire (PHQ9).

Who we treat

Each year, we treat 128 clients in the SHARE Military Initiative.

Client ages

• 18-24: 2%
• 25-34: 12%
• 35-44: 38%
• 45-54: 38%
• 55-64: 9%
• 65+: 2%

Client genders

• Male: 86%
• Female: 14%

Branches of service

SHARE clients represent the following branches of services:

• Army: 60%
• Marine Corps: 15%
• Navy: 13%
• Air Force: 9%
• Coast Guard: 2%
• First Responder: 2%

Average length of stay

• 0-2 weeks: 38%
• 2-4 weeks: 8%
• 4-8 weeks: 15%
• 8-12 weeks: 24%
• 12-16 weeks: 12%
• 16-20 weeks: 2%
• 20 weeks or more: 2%

Client satisfaction

When asked about the likelihood of their recommending Shepherd Center, patients or their caregivers rated Shepherd Center 100 out of 100.

Improvements in abilities, adjustments, and participation during rehabilitation

At Shepherd Center, we track significant improvements in your abilities, adjustments to your daily life, and participation in activities while under our care. These improvements are measured using the Mayo-Portland Adaptability Inventory, which evaluates challenges to community reintegration and social and physical environments. Assessments are made at admission and again at discharge. Lower score indicate greater integration.

Note: Research tells us that a 5-point charge or higher from admission to discharge on the total score is a meaningful improvement.

Ability

• Admission score: 43 (mild to moderate impairment)
• Discharge score: 34 (mild impairment)
• Improvement: Clients improved their ability score by an average of 9 points from admission to discharge

Adjustment

• Admission score: 50 (mild to moderate impairment)
• Discharge score: 39 (mild impairment)
• Improvement: Clients improved their adjustment score by an average of 11 points from admission to discharge

Participation

• Admission score: 40 (mild impairment)
• Discharge score: 34 (mild impairment)
• Improvement: Clients improved their participation score by an average of 6 points from admission to discharge

Overall progress (ability, adjustment, and participation)

• Admission score: 42 (mild to moderate impairment)
• Discharge score: 31 (no limitations)
• Improvement: Clients improved their total scores by an average of 11 points from admission to discharge

Person-center goals

89% of SHARE clients reach or exceed the expected performance of their person-centered goals. Clients work with their therapy team to come up with goals. These goals may focus on physical or mental abilities that patients want to return to doing, or it can be something new. A few examples include:

• “I want to be able to cook a meal with my grandchildren.”
• “I can manage my household finances.”
• “I want to be able to feed myself.”