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Acute rehabilitation unit at Scripps Memorial Encinitas to close

Hermes Castro walks with a help of an Ekso Bionics exoskeleton at Scripps Memorial Hospital Encinitas. Physical therapist Alyson Cavanaugh monitors Castro and the device. The exoskeleton is the first one in the county. Castro is a paraplegic patient who was hit by a vehicle while riding his bicycle.
Hermes Castro walks with a help of an Ekso Bionics exoskeleton at Scripps Memorial Hospital Encinitas. Physical therapist Alyson Cavanaugh monitors Castro and the device. The exoskeleton is the first one in the county. Castro is a paraplegic patient who was hit by a vehicle while riding his bicycle.
(K.C. Alfred
)
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Citing a need for more space and a trend toward outpatient care, Scripps Health will close the rehabilitation unit at its Encinitas hospital in early January, company officials confirmed recently.

Scripps Chief Executive Officer Chris Van Gorder notified personnel of the impending closure in a memo sent to all staff, physicians and management currently working at Scripps Memorial Hospital Encinitas on Oct. 23. The email said that a booming emergency department at the coastal facility, combined with declining use of the hospital’s 30-bed acute rehabilitation unit, have made its closure necessary.

Carl Etter, the executive vice president who runs Scripps’ northern division, said Wednesday, Nov. 6, that the closure directly affects about 50 employees who currently work in the department. All, he said, will move to equivalent jobs elsewhere in the Scripps system or will have the opportunity to train for a different position. In the vast majority of cases, he said, equivalent positions have already been identified.

“I would say that less than a handful have not already identified other opportunities at Scripps,” Etter said.

State data seems to back up the reasons Scripps is citing for the closure of a unit that was the system’s only acute rehab facility in the county where many have worked their way back from severe brain injury, stroke and other debilitating medical conditions.

According to records on file with California’s Office of Statewide Health Planning and Development, Scripps Encinitas saw a 20 percent increase in its overall emergency department traffic from 2013 to 2018 with a 32 percent increase in the number of emergency cases admitted for hospital stays. At the same time, the rehabilitation center has seen its patient load decrease 36 percent during the same five-year span. The change has been even more dramatic over the past decade, Etter said, with a 46 percent increase in emergency visits, a 70 percent increase in admissions from the emergency department and a 42 percent decline in use of acute rehabilitation beds.

Dr. Scott Eisman, Scripps’ chief operational executive for physicians, said that there has been a significant trend in recent years toward handling most rehabilitation cases on an outpatient basis or in skilled nursing facilities. There will still be a need for some patients — especially those with severe brain and spine injuries — to stay at a hospital for long periods while they rehabilitate, and Eisman said that Scripps is working to identify a suitable facility in the community to partner with.

“We are trying to find a location that is geographically optimal,” Eisman said.

Though it has fewer beds than some dedicated acute rehabilitation hospitals in the region, the Scripps Encinitas facility has long been well supported by the community with donations paying for a range of cutting-edge technology including a $100,000 wearable robotic exoskeleton delivered with the help of a grant in 2013.

The rehab unit was renamed in honor of donors LaVerne and Blaine Briggs in 2013 in recognition of their extensive contributions which helped pay for the robotic device, an Alter-G anti-gravity treadmill and driving simulator as well as for specialized nurse and therapist training. Blaine Briggs did not respond to requests for comment on the closure.

Etter said that Scripps has plans to make sure the donations are not forgotten.

“I want to assure all of our donors that this equipment is portable and usable for outpatient rehabilitation, and we will continue to use it,” Etter said.

— Paul Sisson is a reporter for The San Diego Union Tribune

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