Right Care. Right Place. Right Time.

Physician and consult team personalize discharge plans for patients to ensure successful transitions

Dr. Greg Worsowicz interacts with a patient.

To meet Greg Worsowicz, MD, MBA, is to meet someone who is passionate about his job. He gets energized when interacting with patients and learning about their lives, family and medical situation. He loves taking that information and determining the best place for patients after they leave the hospital. 

As chair of the MU Department of Physical Medicine and Rehabilitation and medical director of the Rusk Rehabilitation Center, Worsowicz consults with physicians, nurses, case managers and social workers about a patient’s ongoing medical and rehabilitation needs before they are ready to be discharged from the hospital.

“At the hospital, a patient receives a lot of medical care and varying degrees of rehabilitation,” Worsowicz says. “At some point, they may need more rehab and less medical care. That’s where rehab consults come into play. We look at several factors to ensure the patient is transitioned to the most appropriate place or level of care.” 

Those factors include the patient’s medical, functional, social, financial and geographic situation. For example, does the patient’s home have stairs? Who will be the primary caregiver at home, if anyone?   

Taking this information into account, the consult team provides facility recommendations to the patient and their care teams. In some situations, the patient may be cleared to go straight home, with follow-up care received at an outpatient therapy clinic or through home health visits. In other situations, the patient may be encouraged to go to an inpatient rehabilitation hospital, a skilled nursing facility or long-term hospital. 

“Each facility has a different amount of physician coverage, therapy options and specialized services,” says John Dawes, chief executive officer of the Rusk Rehabilitation Center. “People with more rehabilitative and medical needs, such as a brain injury or a stroke, will often times go to an inpatient rehab facility, such as Rusk. We’re proud of our collaborative relationship with MU Health Care and the work that Dr. Worsowicz’s team does to guide patients on their road to recovery.”

Inpatient rehabilitation facilities and skilled nursing facilities cater to patients with different needs. Patients at Rusk undergo intensive rehabilitation therapy — typically three hours a day — and are closely monitored by physicians with specialized rehabilitation training. But not every patient will require or tolerate such intensive care. For these individuals, a skilled nursing facility may be a better fit.   

After leaving a Des Moines hospital, Skyler Gray of Milan, Missouri, knew she needed the kind of intensive therapy offered at Rusk in order to get back to her daily life. 

“I wanted to regain some form of independence and knew that Rusk would be a great fit,” Gray said, now 23. “Feeding myself and writing were two skills I was really happy to get back. I’ll never forget writing the alphabet for the first time.” 

For Worsowicz, the goal is to ensure the patient gets to the right facility and receives appropriate care while they are there, all in an effort to lower chances of hospital re-admittance and provide better overall outcomes.

“They save lives at the hospital; we give people their lives back,” Worsowicz says. Just because you’re discharged from the hospital doesn’t mean we stop caring for you.”

*Rusk is a joint venture of HealthSouth and the University of Missouri