Blythedale Children's Hospital

Inpatient services - Blythedale Children's Hospital, founded in 1891, is a licensed acute care free-standing Children's Hospital that specializes in the care of children requiring rehabilitative, respiratory and complex medical care. Blythedale is designated by cms as a pps exempt, freestanding Children's Hospital. Within Blythedale Children's Hospital, we provide a comprehensive range of services which include but are not limited to general pediatrics, adolescent medicine, pediatric pulmonology, child neurology, psychiatry, orthopedics, physical medicine, rehabilitation of multiple pediatric specialties (such as cardiology, infectious disease, ent, ophthalmology, etc.) Blythedale maintains a core group of full-time specialty coverage in pediatrics, pulmonology, adolescent medicine, neurology, and psychiatry. Other subspecialty coverage is maintained and utilized as needed through a variety of contractual relationships with the area's leading academic medical centers. Blythedale also provides other vital clinical services such as nursing, respiratory therapy, psychology, child life, respiratory, speech, occupational and physical therapy, therapeutic recreation, social work and case management. The inpatient services are primarily composed of 5 major programs, physical medicine and rehabilitation services, ventilator weaning, traumatic brain injury, feeding therapy, and medical therapies for complex and chronic health conditions.in 2022, the Hospital operated 94 licensed acute beds, and 24 pediatric long term care beds for a total of 118 licensed beds. In 2021 the Hospital added 8 acute tbi beds, making Blythedale the largest inpatient post-acute tbi program in the region. The Hospital provided care to over 353 inpatients throughout 2022. The Hospital ran an average inpatient acute daily census of 79.5 in 2022. Blythedale received over 806 regional referrals in the year and had 426 admissions. Over 83% of our admissions were reimbursed through the medicaid program in 2022. 100% of Blythedale' s inpatient population is referred in from other acute care hospitals in the region, of which 51% are referred directly from intensive care units (icu's). This speaks to the high acuity of the patient population managed at Blythedale. In 2022 almost 64% of patients treated were below the age of 6 years. This fact presents many unique challenges to the delivery of care as the Hospital provides high quality to both the patients and the family. Blythedale strives to discharge all of our kids back to their home after admission. Blythedale Children's Hospital doesn't operate primary care clinics, an emergency department or obstetrical services. These services are often the primary drivers of uninsured patients at acute care hospitals. Secondly, children, more so than adults have greater access to medicaid & child health plus (chp) reimbursement as a payer of last resort in new york state. These two factors significantly impact the reported amount of care classified as true charity care relative to full service acute care hospitals.

The day Hospital program - Blythedale offers a day Hospital program for those children who are able to live at home, but still require a level of medical and rehabilitative care that cannot be met by their school or outpatient program. In 2022, Blythedale treated 229 children in the program. The program continued to be impacted by covid through 2022, but the Hospital managed to continue treating our medically fragile children through a mix of on-site therapy and teletherapy. Roughly 30+ % of the program comes directly from Blythedale' s inpatient setting, while the balance come directly from referrals in the community and through the early intervention/cpse programs throughout the region. In 2022, the day Hospital served on average of 89 patients per school day for a total of 17,325 visits. Over 80+% of these patients were reimbursed by the medicaid program. The day Hospital program provides a nurturing environment where children with various special medical needs can receive daily medical supervision, nursing care, and have their needs for physical, occupational and speech therapies met, all while returning home at the end of the day. Each child's program is individualized to address their unique medical, psychological and therapeutic needs. In addition, every child is assigned a social worker to provide family support and case management. As necessary, ongoing psychosocial support and counseling, and case management are provided. Services for school-age children are provided in conjunction with a full academic program under the auspices of the mount pleasant-blythedale union free school district.the cpse program - committee on preschool special education (cpse program): Blythedale Children's Hospital provides evaluation and treatment services for young children between the ages of 3 to 5 years who are referred through their local committee on preschool special education (cpse). These patients are eligible for assessment at no cost to their families. The new york state education department oversees a statewide preschool special education program with school districts, municipalities, approved providers, and parents. Evaluations and services are provided to eligible children who have a disability that affects their learning. Funding for evaluations and services is provided by municipalities and the state. In 2022, the program served 39 patients for a total of 3,495 visits. Evaluation and treatment planning are performed by a multidisciplinary team that may consist of therapists, special education teachers, audiologists, physiatrists (rehabilitation doctors), neurologists, psychiatrists, psychologists, social workers, nurses, nutritionists, and other specialty consultants.

The steven and alexandra cohen pediatric long term care pavilion, which opened in fall 2016, is a unique 24-bed facility dedicated to the highly specialized needs of infants and children who require extended medical care and rehabilitation. In 2022, the Hospital cared for 29 children and ran an average occupancy of 99.5%. 33% of the children were under the age of 6, 96.5% were reimbursed through the medicaid program and 100% required ventilator-respiratory support. The pavilion serves children with complex medical needs, including those who require a longer period of time to be weaned from the ventilator, and premature infants with feeding difficulties, congenital conditions or neurological disorders. The pavilion is staffed by a full-time pediatrician who works in consultation with a variety of pediatric subspecialists including pediatric pulmonology, pediatric physical medicine and rehabilitation, and pediatric neurology. The comprehensive team also include registered nurses, certified respiratory therapists, physical/occupational/speech therapists, recreational therapists, child psychologists, child life specialists and a dedicated social worker. Features of the pavilion include 11 double-bedded rooms and two private rooms, all with piped-in oxygen, a spacious dining and recreation area, dedicated therapy space, an infant playroom and teen lounge. An attractive courtyard includes play areas, walking paths and sitting areas for residents and their families. Children in the pediatric long term care unit have access to education through the on-site mt. Pleasant-blythedale school and early childhood center, and recreational programming on evenings, weekends and holidays. Family involvement is a key component of care at Blythedale, and progress toward goals (established upon admission) will be reviewed during periodic family conferences. An interdisciplinary approach to treatment is a hallmark of Blythedale, and each patient's clinical care team will meet every two weeks to discuss the individualized plan from every perspective: medical, social, psychological, and educational.

In 2022, the Hospital provided 3,543 outpatient therapy, teletherapy, and specialty clinic visits to 535 children in the region. Blythedale Children's Hospital is well suited to provide evaluation and treatment services for young children. As the region's premiere Hospital offering rehabilitative services to children, we have the largest departments of speech therapy, occupational therapy and physical therapy. The expertise of our highly skilled, multidisciplinary staff enables us to provide coordinated, comprehensive, individualized programs for the children and families we serve. Parents and staff work closely together to develop goals. Evaluation and treatment planning are performed by a multi-disciplinary team that may consist of therapists, physiatrists (rehabilitation doctors), neurologists, psychiatrists, psychologists, special education, teachers, audiologists, social workers, nurses, nutritionists, and other specialty consultants. While not limited to the following, the program treats a wide array of issues and diagnoses including delays or lags in reaching their developmental milestones, congenital or acquired abnormalities such as vision or hearing impairments, diagnosed medical conditions such as cerebral palsy, neuromuscular or other neurological disordersblythedale Children's Hospital is a downstream care management agency for medically fragile children under the umbrella of new york state's health home serving children program. Our proactive care coordination model provides members and their families with the support needed to promote more consistent medical care, a reduction in unnecessary hospitalizations, and the achievement of medical and therapeutic goals. The model includes monthly in-home visits with the child and family, 24 hour/7 days a week access to care management support, and coordination of care and services across the medical, behavioral health, educational, and social spectrum. Social determinants of health including access to transportation, food security, and health literacy are also considered by the care manager. We are currently partnered with montefiore health home to provide services in the bronx and with skyward health to provide services in westchester county, 2 of our largest regional catchment areas. Member capacity is currently between 40 and 45 members but will increase to at least 65-70 by 2023. Our care managers are bilingual to allow for better service for our spanish-speaking members.