At first, Encompass Health Corp.’s pitch to build an inpatient rehabilitation hospital was met with objections from local health care leaders who argued that the facility would duplicate existing services and possibly increase health care costs.
Now less than a year after the rehab hospital opened, health care professionals are celebrating its success.
Encompass Health, an Alabama-based for-profit company with more than 150 hospitals in the U.S., first proposed building a 50-patient rehabilitation hospital in Johnston in 2019.
But the opposition included leaders of the Hospital Association of Rhode Island and the Rhode Island Health Care Association. In 2020, those groups argued that a new rehab center would “cannibalize” existing resources and that the state’s five inpatient rehabilitation hospitals, with a total of 109 beds, and skilled nursing facilities were enough to meet Rhode Islanders’ needs.
Encompass’ effort to receive a certificate of need from the R.I. Department of Health led to a series of decisions and reversals that ultimately reached the R.I. Supreme Court, which sided with Encompass in December 2022.
Since then, the critics of the new inpatient rehab hospital have more than warmed to it.
Lisa Tomasso, senior vice president of the Hospital Association of Rhode Island, says that in recent years it’s become clear that expanding post-acute care – the “in-between” stage when a patient isn’t quite ready to care for themselves – can open more beds in primary care hospitals and improve the results for patients.
“Encompass Health’s presence in Johnston adds essential services that support patients in regaining function and independence at a time when the health care system requires more, not fewer, options for patient recovery,” Tomasso said.
Since the COVID-19 pandemic, the state’s hospitals and providers have continued to face workforce shortages and more demand for specialized care, Tomasso says. Encompass Health became a member of the association a year ago.
Also, several skilled nursing facilities have limited their capacity, changed their business model or closed entirely, straining the state’s ability to care for its growing aging population.
As a result, patients have remained in hospitals or emergency departments while they wait for a bed at an inpatient rehabilitation facility to open.
Between July 29, 2024 – when Encompass Health Rehabilitation Hospital of Johnston admitted its first patient – and early March, it has had more than 415 patients stay at the facility, according to hospital CEO Daniel Parkinson.
The patients arrive from local primary care hospitals where they have been treated for ailments such as strokes, brain injuries, Parkinson’s disease and multiple sclerosis. Or they underwent procedures such as hip replacement or spinal surgery. Encompass has also admitted patients directly from home and some from nursing homes who needed more-intense therapy services.
Parkinson says the idea is to provide medical support and rehabilitation outside of an acute-care hospital before people fully recover and return home.
“We work with patients and their families and loved ones right from the minute they come through the door to help them to get stronger and safely return to the community,” Parkinson said.
On average, patients stay at Encompass for just under two weeks. Each patient receives three hours of some form of therapy five days a week, Parkinson says, noting that it is much more than the average 30 minutes to 45 minutes of therapy patients in nursing homes receive.
Depending on their needs, patients receive a mix of speech, occupational and physical therapy.
The amenities inside include private patient rooms, an in-house dialysis suite, a pharmacy, a dining room and a gym with rehabilitation tools such as a mock car for patients to practice getting in and out.
Encompass Health chose Johnston for the hospital because of its central location in Rhode Island, making it easier to access for patients throughout the state.
When Encompass Health proposed the project in 2019, it expected the project would cost about $42.5 million. Parkinson did not have a more recent figure and said Encompass Health covered the construction costs.
Parkinson acknowledges that Encompass Health has struggled to get the rehab hospital fully staffed since it opened last year.
As of early March, the hospital had 110 full-time employees, and Encompass is looking to hire another 10 nurses.
Indeed, hospitals and health care facilities – especially nursing homes – in Rhode Island have been facing staffing shortages after many workers left in the wake of the pandemic.
To attract talent, Encompass Health hosted a job fair in downtown Providence, which 145 people attended, and the company has continued recruiting workers.
“People were really excited about opening a new hospital and with that comes the idea of building a culture,” Parkinson said.
