Shirley Ryan AbilityLab

The Rehabilitation Institute of Chicago (RIC) was founded in 1951 as, an Illinois not-for-profit corporation. In 2017 RIC with 182 beds, began doing business as the Shirley Ryan Abilitylab (SRAlab) and moved to a new building with 242 licensed beds. This move brought not only a physical change of address but a whole new model to the field of rehabilitation. Upon opening the 1.2-million-square-foot building, SRAlab became the first-ever "translational" rehabilitation research hospital in which clinicians, scientists, innovators and technologists work together in the same space, surrounding patients, discovering new approaches and applying (or "translating") research in real time. SRAlab's vision is to advance human ability through science and research. The organization has earned the distinction of being named the nation's #1-ranked provider of comprehensive physical medicine and rehabilitation care to patients from around the world every year since the designation's inception in 1992 by U.S. News & World Report - a record for any U.S. hospital. In addition to being a large rehabilitation hospital SRAlab is the nation's largest rehabilitation research enterprise, advancing the field globally through innovation of the most advanced treatments and technologies. For FY 2023 SRAlab's system of care included a 262-bed hospital located at 355 East Erie Street in Chicago and numerous outpatient programs in the Chicago metropolitan area and surrounding suburbs. In addition, we manage the rehabilitation service line in several acute care hospitals through our strategic alliance platform, primarily in the Chicagoland area; however, this year, we also extended our reach to Minneapolis where we have a new alliance partner, Hennepin Healthcare. The Corporation offers a comprehensive range of inpatient, day rehabilitation and outpatient rehabilitation services. Inpatient rehabilitation services are provided using an interdisciplinary approach with a team bringing unique skills and knowledge to ensure patients achieve the best possible outcomes. Day rehabilitation is a similar model to inpatient in that it consists of an interdisciplinary approach for individuals. Once the patient does not require 24-hour nursing care and daily medical management, we are able to transition patients to the day rehabilitation model. Outpatient care is typically a singular discipline (e.g., physical therapy) and offers various levels of therapeutic intensity, depending on the patient's needs and goals. In FY 2023 we grew our net operating income and outperformed our operating EBITDA from the previous year. Our total net revenue grew by 7.2% resulting in $1.2M in net operating revenue finishing the year $3.1M better than budget. We decreased days in accounts receivable by 28% in FY23 with a total cash impact of more than $20M over last 30 months. We improved financial ratios and exceeded debt covenant metrics, including debt service coverage ratio and days cash on hand (more than 350 days at year-end). In addition, our Fitch Ratings affirmed Shirley Ryan AbilityLab's A credit rating with a stable outlook. Inpatient admissions grew, particularly through our global network with 54% growth since 2021, bringing patients in from around the world. Both the day rehabilitation and outpatient therapy programs grew year over year. Our total research grant portfolio exceeds $150M. Through our research enterprise, SRAlab offers the ability for patients to participate in clinical trials at the same time they are receiving clinical care. Since inception SRAlab has worked relentlessly to develop and implement interventions that drive the very best outcomes. SRAlab serves patients with the most complex conditions with multiple medical and rehabilitation issues. This year, the Advancement Department launched our Accelerate Ability Campaign with an aim to raise money to support research initiatives and quality of life programs. We raised more than $60M toward a $100M goal. In addition, we announced a new and unique partnership with Henry Ford Hospital, the Gilbert Family Foundation and Michigan State University which will allow us to bring our world-class care to the Detroit market. It is the mission of SRAlab to not only focus on our patients but to also elevate the entire rehabilitation field. In FY 2023, SRAlab clinicians, physicians and researchers shared over 100 presentations to various professional audiences as well as published more than 50 papers on scientific and clinical advancements. SRAlab continues to focus on providing a number of unreimbursed services improving the quality of life for our patients. These services include vocational rehabilitation, virtual education and consumer health resources available free of charge to all through our LIFE (Learning Innovation, Family and Empowerment) Center web site, and adaptive sports and fitness services for children and adults. Finally, SRAlab launched the Robert R. McCormick Center for Hope & Equity to provide needed education for our staff and wraparound services for our patients who come from vulnerable communities.

Medical Education: The Department of Physical Medicine and Rehabilitation at Northwestern University's Feinberg School of Medicine (Dept of PM&R) is housed within SRAlab, which has one of the largest and most highly respected residency programs in Physical Medicine and Rehabilitation in the country. Resident physicians spend three to four years rotating through the Dept of PM&R, taught by SRAlab physicians who are experts in this special, In FY 2023 SRAlab trained 52 residents. The SRAlab medical education program also provides opportunities for fourth year medical students from Northwestern University Feinberg School of Medicine to rotate in a rehabilitation setting to gain experience with spinal cord injury, brain injury, amputee rehabilitation, cancer rehabilitation, medically complex rehabilitation, and pediatric rehabilitation. There are approximately 180 medical students from Northwestern that rotate with us and additional 50 medical students from other medical school nationally that rotate with us. Fellowships: SRAlab offers 5 physician sub-specialty fellowships, funded primarily by donations, in Sports Medicine, Pain Medicine, Pediatric Rehabilitation, Brain Injury Rehabilitation, and Spinal Cord Injury Rehabilitation. In FY 2023, 13 physician fellows were named at SRAlab, 2 in Spinal Cord Medicine, 4 in Sports Medicine, 3 in Pediatric Rehabilitation, 2 in Brain Injury Medicine, and 2 in Pain Medicine. SRAlab also supports residencies for therapists, nurses and other non-physicians. Prosthetics and Orthotics (P&O) Residency: Each year, SRAlab's Prosthetics and Orthotics Clinical Center (POCC) selects three prosthetist and three orthotist residents for these highly sought after positions. The orthotics residency is a 12-month program and the prosthetics residency is an 18-month program to allow additional hands-on experience in research through our Center for Bionic Medicine. Through these training programs, P&O residents are mentored by SRAlab's certified, licensed professionals and get exposure to a variety of clinical presentations and pathologies, clinical evaluation, prescription recommendation, documentation, the actual fabrication of devices, and formal research. The Academy offers continuing education aimed at helping rehabilitation professionals stay at the forefront of their field since 1954. In FY 2023, over ten thousand students participated in academy programs which are taught by interdisciplinary teams of recognized specialists from SRAlab and visiting experts from around the world. These programs were offered in a variety of formats including webinars, courses, and workshops that were delivered in a range of formats including online, in-person and hybrid. We expanded our outreach to international participants who were able to participate in asynchronous and live programming that fit with their time zone. We have over 180 titles in our catalog and continue to receive the highest quality reviews from our attendees.

Research Program: SRAlab's Research Program is the world's largest physical rehabilitation research enterprise in pursuit of clinical advancement through scientific discovery. In Fiscal Year 2023, the Research Program had approximately 120 research projects underway, funded by more than $153 million in grants and donations from both private and public sources. Its experts regularly publish research in the world's foremost medical journals, including the Journal of the American Medical Association (JAMA) and its European equivalent, The Lancet, and it is home to six federal research designations to develop cutting-edge solutions for patients. Biologics Lab and Aphasia Research Integration: We have integrated our biologics laboratory with the rest of the hospital in the aphasia research program. We are now genetically sequencing patients in the stroke rehabilitation program to understand the genetic basis (if any) for response to therapy. This work was funded by NIDILRR. The NIDILRR-funded center is especially for patients with hemispheric stroke - the most debilitating kind. This year, we will also begin the first-of-its-kind drug repurposing study for children with cerebral palsy. Manipulation and Mobility Technologies: A NIDILRR-funded Rehabilitation Engineering Research Center award to fund six new projects researching innovations that are directly useful for patients, especially those who have experienced limb-loss or stroke. Projects include body-powered hand prostheses, use of powered exoskeleton for after-stroke patients, and a new wheelchair to allow both sitting and standing. Research will include both technology development and clinical testing. Health and Function in Physical Disability: This Rehabilitation and Training Center, funded by NIDILRR, was created to develop, evaluate, and implement methods to promote optimal health and function of people with physical disabilities. Through a variety of research, training and dissemination activities, we expect to gain a more comprehensive understanding of the efficacy and value of various interventions for achieving and maintaining health and function for people with a disability. Spinal Cord Injury Research: SRAlab operates the Midwest Regional Spinal Cord Injury Care System as designated by NIDILRR. One of only 14 SCI Model Systems nationwide, SRAlab advances spinal cord care through clinical research that identifies new standards of care for the industry. It leads multiple independent and collaborative research projects exploring walking therapy technologies that deliver the most effective treatment to advance ability. This year we began an exclusive study of pharmacological treatment of chronic spinal cord injury as the only center in the world with this drug. Engineering Research: This project established a NIDILRR-funded Rehabilitation Engineering Research Center, Collaborative Machines Enhancing Therapies (COMET), focusing on advancing technologies that work in partnership with patients and clinicians to enhance gait and dexterity outcomes for individuals with stroke and spinal cord injury (SCI) and other people with disabilities in a real-life rehabilitation setting. This project is based at SRAlab and leads four other major research universities around the United States. Wearable and Mobile Sensors: This center continues the "Center for Smart Use of Technologies to Assess Real World Outcomes" known as (CSTAR). This center serves as a national resource for rehabilitation professionals attempting to measure patient function in objective manners outside of the traditional clinical environment. Our partnership allows us to leverage the collective experience of our clinicians, scientists, engineers, and patients to provide the expertise, instruction, and mentoring to support the smart use of technology. Rapid Non-Invasive Screening for Covid-19: Controlling the spread of the COVID-19 pandemic largely depends on scaling up the testing infrastructure for identifying infected individuals. This project establishes a novel paradigm based on recording the physiological responses elicited by a short (~2 minutes) sequence of activities (i.e. "snapshot"), to detect symptoms associated with COVID-19. We are employing a novel body-conforming soft wearable sensor placed on the suprasternal notch to capture data on physical activity, cardio-respiratory function, and cough sounds. Early results, although preliminary, suggest that a sensor-based snapshot paradigm may be a promising approach for non-invasive and repeatable testing to alert individuals that need further screening.

SRAlab's Henry B. Betts LIFE Center is a virtual and multimedia education center providing patient education and consumer health information for patients, families, staff and the community. Everything in the collection relates in some way to people living with a wide range of cognitive and physical impairments, chronic conditions or diseases affecting function. The website enables individuals across the globe to have access to current, peer-reviewed patient education and consumer health resources with real-time updates, printing on demand and a dashboard to save favorite resources for easy access. Resources such as the LIFE Center help individuals and their families navigate the intricacies of health care and minimize the complexity of relevant health information. Having access to information empowers people to partner with their health care team in order to make the best choices for themselves, their families and engage in life-long learning. The Center's resources are organized according to eight topic areas: Medical Information and Care, Caregiving and Equipment, Housing and Transportation, Education and Employment, Support and Wellness, Recreation and Leisure, Finance and Law and Inspiration and Hope. LIFE web traffic in FY 2023 averaged 13,023 page views per month, up from 12,113 page views per month in FY 2022, with 156,274 page views annually, up from 145,353 page views annually in FY 2022 from more than 174 countries. This past year, the highest international web activity occurred in the United States, United Kingdom, Australia, Canada, Italy, China, Mexico, and Switzerland. In FY 2023, total outreach and service efforts apart from web activity was 8,007 person contacts served which includes programs, classes, special events, resource requests, teaching activities and tours for patients, families, staff and the community. This total is up from the 6,312 person contacts in FY2022. Sports and Fitness Program: The SRAlab Adaptive Sports and Fitness Program provides wellness opportunities to people with physical disabilities through sports and recreation as well as an accessible Fitness Center. All services offered in the adaptive sports program, which marked its 42nd year in FY 2023, are free of charge. The fitness programs, which celebrated its 27th anniversary, provides access to a health club that operates from 6:15 am to 7 pm five days per week for a nominal annual fee. The sports and fitness program is funded primarily by grants and generous community donations and is operated by eleven full time equivalent staff. Additionally, volunteers logged nearly 7500 hours in FY 2023. The Shirley Ryan Adaptive Sports and Fitness Program is considered a national leader in health promotion for people with disabilities. In FY 2023 we continued to expand programming developing innovative wellness opportunities for persons living with disabilities. The sports program recorded over 5200 visits by 483 registered participants, and the fitness program continues to provide services virtually, as well as, in person recording 5,800 one-on-one visits by its 200 registered participants in addition to 4,837 class visits, classes are held in person and virtually. A separate program for youth, the Tengelsen Family Foundation Sports for Kids program, recorded 655 visits by 88 Chicago area children with disabilities. Adaptive Sports and Fitness programs continue to develop community partnerships and collaborations that open doors for people living with a disability to lead an active healthy lifestyle Vocational Rehabilitation Program: Beginning a career or returning to work following an illness or injury is important to a patient's financial security and emotional well-being. It can contribute to the achievement of a productive, independent and fulfilling life. For more than 50 years, the SRAlab has been providing comprehensive vocational rehabilitation services tailored to meet the needs of each client. Services include initial assessment, vocational counseling and guidance, diagnostic evaluation, work trial assessments, job analysis, return-to-work evaluations, job placement, resume writing, job interview workshops and internship coordination. The SRAlab covers the cost of initial assessments, which are not covered by most third-party payers. Patients receive vocational services at nine SRAlab facilities or via telehealth, ensuring that employment assistance is closely tied to community reintegration. During FY 2023 the program served 918 clients. In the last year, we placed 41 individuals in jobs. We continue to provide no cost GED program for patients with spinal cord injuries to our list of services. Assistive Technology Programs: The Technology Center and the Wheelchair & Seating Center, comprise SRAlab's Assistive Technology Programs. In FY 2023, the Assistive Technology Programs served approximately 3,184 unique patients. The SRAlab Technology Center provides computer access training, smartphone/tablet access, augmentative communication evaluations/treatment, and electronic aids to daily living, including recommendations for home automation and modifications, for people with different or changing abilities. Occupational therapists and speech language pathologists evaluate and recommend equipment for each individual's needs. Through a lending library, or support from manufacturers facilitated by Technology Center staff, patients can try some items before purchasing them or borrow them for short-term use due to changing needs. Staff members speak to universities, schools, organizations for people with disabilities, senior centers and the general public. We also provide continuing education lectures in assistive technology through assistive tech conferences and the SRALAB Academy. The center provides 1 to 2 home visits if the client can no longer come to SRALab following their evaluation. We have also integrated the use of telehealth appointments over the past year. Staff recommend applying for SRALab charity funds if Patient's insurance is maxed out. The Technology Center served a total of 1430 clients representing 589 inpatients, 374 Day Rehab clients, and 467 outpatients in the past fiscal year Rehabilitation Engineering staff collaborate with allied health clinicians to provide consultation, evaluation, and design of individual solutions to aid persons with different abilities to complete activities of daily living with increased independence at home, work, and in the community. The team fabricates custom equipment and modifies commercially available equipment and objects to create unique, individualized solutions to help patients navigate obstacles encountered in daily life. SRAlab provides free care for services and products, and provides real-life design experience to students through Northwestern University's engineering design program. The Wheelchair & Seating Center staff evaluate and make recommendations for complex wheelchairs and customized seating systems for patients with significant mobility and postural needs. This includes manual wheelchairs; powered wheelchairs; custom-made and customized seat and back cushions to relieve pressure, prevent pressure sores, and maintain posture; alternative drive controls like sip and puff and head array systems; that help clients maintain or increase their mobility and independence, at home, work, or in the community. During FY23 the Wheelchair & Seating Center continued to use telehealth appointments to serve our patients that were unable to attend an in person appointment. We served a total of 1754 patients, including 852 inpatients and 902 outpatients this past fiscal year.