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Inpatient Advocacy

A Better Deal for Minnesota Taxpayers

Courage Center fully supports a move to a value-based payment system for nursing homes. But some facilities need to be recognized – and reimbursed – as high-cost, high-value investments.

Proposed legislation allows the Minnesota Department of Human Services to negotiate higher payment rates with specialized facilities like Courage Residence/Transitional Rehabilitation Program (TRP), our inpatient rehabilitation program.

What is the solution?

Please recognize in the Medical Assistance payment levels those facilities designed to provide exceptionally intensive rehabilitation for non-elderly, working age people with disabilities.

What is Courage Residence/TRP?

The Courage Residence/TRP is a 56-bed transitional rehabilitation unit. Even though it is licensed, regulated and reimbursed as a skilled nursing facility (SNF) or nursing home, the level of care provided is more similar to that of a long-term, acute care hospital.

  • Courage Residence/TRP is specially designed for intensive rehabilitation. In addition to physical, occupational and speech therapies, Courage Center provides mental health services, chemical health, aquatics, medical services and assistive technology; as residents stabilize medically, vocational services, driver’s assessment and training and other community integration services are available.
  • The projected 2007 operational deficit for the Residence/TRP will exceed $1 million.
  • Average age of persons served is 42 and includes primarily individuals with newly acquired spinal cord and brain injuries. (The average Minnesota nursing home resident is age 66.)
  • A majority of the 159 people we served in 2007 were funded by Medical Assistance. (Nearly 11,000 MA patient days.)

Positive outcomes: Courage Residence/TRP works

Courage Residence/TRP graduates enjoy integrated, community living. A 2005 longitudinal survey of 600 Residence/TRP graduates revealed:

  • 91 percent have maintained the skills and independence that they gained while in the Residence/TRP
  • 78 percent reported their health was good or excellent
  • 27 percent are college graduates
  • 25 percent are participating in a fitness or wellness program 

Courage Residence/TRP participants overwhelmingly move to a more independent living setting. Average annual costs for a person with a disability in a nursing home is $56,900. Living in the community averages $17,000.

  • 94 percent of residents are discharged to an independent community living setting with increased functional and quality of life outcomes.
  • Clients with a stroke or brain injury make significant gains in abilities such as dressing and self care, emotional adjustment and social participation while they are at Courage Center. 
  • Clients admitted to the Transitional Rehabilitation Program with a spinal cord injury make significant gains in performance of self care tasks, such as dressing, feeding, as well as significant gains in mobility, such as transfers, bed mobility, and wheelchair propulsion or ambulation.
  • The state of Minnesota saves an estimated $11.7 million annually by providing rehab services in the residence, rather than in an acute rehabilitation setting. 
  • The state of Minnesota saves an estimated $6.4 million dollars annually by avoiding long-term institutionalization of those served by Courage Residence’s inpatient transitional rehabilitation program.