Frequently Asked Questions

TIRR is a teaching hospital. As one of the leading rehabilitation Organizations in the United States, with two top medical school Affiliations, Baylor College of Medicine and McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), TIRR attracts nationally and Internationally recognized physicians in the field of physical medicine and rehabilitation (PM&R).Our attending medical staff primarily comprises board-certified PM&R physicians employed by one of two prestigious medical schools who treat a wide range of diagnoses from multiple sclerosis to traumatic brain injury and spinal cord injury.

A physician is available on site 24/7 which allows for quick response to patient needs.

Attending physicians have teaching affiliations and are employed by Baylor College of Medicine and/or McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), and they are instrumental in training future physiatrists*.In addition to its attending physicians, TIRR Memorial Hermann has an equally impressive roster of physicians with consulting relationships who bring expertise in a number of specialized areas of medicine related to rehabilitation.

A physician is available onsite 24/7, which allows for quick response to patient needs. Hospitalists are also available on site to assist in providing patient care. Physicians who specialize in Internal Medicine are often consulted to assist with the management of a patient's care.

*Physiatrists, or rehabilitation physicians, are nerve, muscle and bone experts who treat injuries or illnesses that affect how you move. Rehabilitation physicians have completed training in the medical specialty of physical medicine and rehabilitation (PM&R).

One nurse and one patient care assistant (PCA) are assigned to care for five to six patients.

Cost for inpatient rehabilitation is based on a patient’s acuity (need for rehabilitation). A medical evaluation is needed to establish what the patient’s rehabilitation needs will be, then a projected cost can be established.

Patients admitted to the pediatric program must be aged 6 months through 18 years. We provide a seamless transition from pediatric to adult care. When it’s time for your adolescent to transition to adult rehabilitation, they are able to stay within the TIRR Memorial Hermann system to continue their care without losing progress.

A patient is admitted to TIRR only after a thorough pre-admission screening has been conducted by our nurse liaisons and admissions representatives, and the patient has been deemed appropriate for admission both medically and financially.

No, patients living at home who want to be evaluated for inpatient rehabilitation are encouraged to make an appointment in our clinic for a physician by calling (713) 797-5929.

The amount of time that a patient is hospitalized at TIRR Memorial Hermann is dependent on the patient’s therapy progress and goals, as well as medical needs. The interdisciplinary care team will meet weekly to review progress against goals and determine the length of time necessary to meet any remaining goals that have been established for the patient.

A patient’s estimated health transition date will be determined during the first week of admission after a full evaluation by the care team. However, during a patient’s stay the estimated health transition date can be moved up or back, depending on patient progress and appropriateness for inpatient rehabilitation.

For a patient to remain an inpatient at TIRR, the following criteria must be met:

• The patient must require intensive rehabilitation, meaning that the patient must generally require, be able to participate in, and benefit significantly from, at least three hours of therapy per day, five days per week.
• The patient must require the active and ongoing therapeutic intervention of at least two therapy disciplines(physical therapy, occupational therapy, speech therapy, or prosthetics/orthotics therapy), one of which must be physical or occupational therapy.
• The patient must require 24-hour rehabilitation nursing care.
• Significant practical improvement is expected in a reasonable amount of time.

When these criteria are no longer met, the patient is no longer making progress toward goals, or the patient is no longer participating in the plan of care, the inpatient rehabilitation stay is no longer considered medically necessary, and a recommendation for health transition will be made.

The care of each patient admitted to TIRR is managed by a full interdisciplinary team of highly qualified individuals with specialized training in the field of rehabilitation. The team, led by a physician who specializes in physical medicine and rehabilitation, includes physical therapists, occupational therapists, speech therapists, music therapists, rehabilitation nurses, pharmacists, social workers, case managers, dietitians, therapeutic recreation specialists, neuropsychologists and respiratory therapists. Each team member contributes to the overall plan of care for the patient.

The role of a caregiver is critical to the rehabilitation process. Throughout the rehab stay, we are committed to teaching you the information and skills needed to care for your loved one. We will provide opportunities to practice new skills with guidance from our staff. We encourage involvement in daily care and decision making. Your participation is valued and encouraged; we invite you to attend therapies and collaborate with all members of the rehab team. The entire care team will be guides to ensure you feel comfortable as you prepare to leave this setting.

A wide variety of diagnostic imaging services is available on site, including diagnostic imaging: (X-rays), fluoroscopic studies, ultrasound and Doppler studies, as well as other medical support services such as pharmacy, clinical laboratory, urodynamics, and specialty physician clinics. The availability of these on-site services allows for a timely response to all inpatient referrals.

Diagnostic imaging, pharmacy and clinical laboratory staff are available on site Monday through Friday and weekends during normal business hours, with evening hours and holidays supported by on-call staff. The availability of these on-site services allows for a timely response to all inpatient referrals.

Urodynamics and specialty physician clinic are also available on site Monday through Friday during normal business hours.

If patients should require CT, MRI, nuclear studies, surgical intervention or other services not provided on the TIRR Memorial Hermann campus, they will be scheduled at other facilities in or near the Texas Medical Center.

The philosophy of therapy is to promote recovery of lost movement in addition to teaching functional skills. This promotion of recovery uses hands-on techniques to make the weaker limb(s) move and activate as much as possible.

The range of skills include cognition and communication tasks which work on speaking, processing and memory; activities of daily living which include eating, grooming, dressing, hygiene, bathing and toileting; and mobility skills which include moving in bed, transferring to different surfaces (car, furniture, wheelchair, bed), standing, walking and climbing stairs.

Aquatic (pool) therapy is available if indicated. It allows the body to be supported while working on strengthening and functional activities, walking, etc.

Bodyweight-supported treadmill training is available as indicated to assist in recovery of walking and standing skills.

The patient’s ability to sit up, the amount of endurance the patient has to tolerate therapy, as well as his or her medical and nursing needs, determine the ability to participate in therapy services. Many factors are involved and decisions are made by the team as to what is most appropriate for the individual.

There are many different therapy groups that support the educational needs, physical needs, cognitive and psychosocial needs of the patient. Therapy groups are just as important as individual treatment sessions. Patients who are on certain restrictions, such as isolation, may be limited in their ability to participate in groups. Group treatment is added to the schedule as the patient’s endurance and medical needs allow.

The goal for acute inpatient rehabilitation is to provide a minimum of three hours of therapy per day, Monday through Friday. The maximum amount of therapy a patient would receive is approximately six hours. Weekend therapy is also offered depending on patient needs and abilities. Practice on the patient care unit, as well as opportunities with rehabilitation nursing, are also important components of the rehabilitation program.

Therapy is provided in many areas. Patient rooms and even hallways can be therapeutic environments depending on the goal for the particular session. Therapy is mostly provided in one of our many gym areas: 1st floor main gym, 2nd floor gym, 3rd floor gym or 4th floor gym.

Patients and families are strongly encouraged to attend all of the relevant education classes we offer, such as RAPS (Readiness and Preparation for Self-care) classes for SCI patients and Family Times for brain injury and stroke patients. The chaplain offers classes and services for all patients and families. Weekend activities and occasional evening activities are also offered and encouraged for patients and families.

Individual weekend therapy (Saturday or Sunday) is offered to patients on a priority basis depending on multiple factors, one of which is the day of the patient’s admission. Therapy groups are also offered to encourage therapeutic progress on the weekends. Your therapy team will work with you to determine what is most appropriate on any given weekend. In addition to therapy groups and individual therapy, other activities are offered for all patients and families on the weekends.

A variety of meal services are offered to our patients and families. Patients can order from a specialized menu in accordance with their physician’s orders, and eat in their rooms. Patients with no dietary restrictions can request to eat in the café with menu choices from the café menu. Dining can be enjoyed with family and friends in the café dining room or in the outdoor patio area.

Hospital visiting hours are from 9 a.m. to 9 p.m. daily. During this time we encourage family members and caregivers to come and participate in family/caregiver training and rounding, as it contributes greatly to the overall plan of care.

Family and friends play an integral part in the healing process and for this reason we encourage visitation and participation. However, children are not allowed to remain in the facility overnight. It is also important to note that a hospital visitation can place children at risk in an environment that has potential for transmitting illness. If you plan to bring children under age 12 to the hospital, it is advised they are not left unattended. Likewise, during certain times of the year, such as flu season, we respectfully request that children not be brought to the hospital for visitation in order to prevent the introduction of seasonal illnesses such as flu to our patients.

There are several parking garages near the hospital and a satellite parking lot on the Texas Medical Center Campus. If you park for five or more consecutive days, you may purchase a TMC Visitor Parking Pass which is less expensive than paying on a daily basis. The card allows visitors unlimited 24-hour in-and-out access to convenient parking for TIRR and most other TMC Campus locations for the amount of days purchased. You may purchase these cards at any Easy Pay station. No refunds or exchanges are possible. Texas Medical Center patient and visitor parking guides are available in the lobbies, Admissions and Social Work departments.

Learn more about local transportation resources here »

The Social Work department maintains a list of local hotels with shuttle service, as well as information on other lodging resources in the area. Please be aware that many of the available services, especially those that are free, often have awaiting list. The Ronald McDonald House, located near TIRR, provides temporary lodging For families with children being treated for serious illnesses in the Texas Medical Center. The age limit for a child is 17 years.

Please call the Social Work department at (713) 797-5201 for more information.

Patients may have an overnight visitor for the purpose of providing emotional support and physical assistance. However, if a patient is a minor only family members or guardians will be permitted to stay overnight. Overnight visitors must follow certain rules, including:

1. Normally, only one visitor may stay overnight.
   • If a patient requests more than one overnight visitor, approval must be obtained from the clinical manager and/or operations administrator (OA).
2. Overnight visitors:
   • Must be 18 or older.
   • Are not allowed to use the patient's equipment or sleep in any patient bed.
   • Should bring their own personal care items (such as toiletries) as these are not provided by the hospital for visitor use.
   • May not stay near staff work areas.
   • Are to be up and dressed and sleeping area cleaned by 7 a.m.
   • Are permitted to shower in the patient's bathroom as long as it does not interfere with the care and hygiene needs of the patients.
   • Are asked to stay in the patient's room after 10 p.m.
   • Should let the staff know by 8 p.m. that they will be staying the night.
3. Visitors will be allowed to stay overnight in an occupied semi-private room; however, approval from the other patient in the room, or that patient's family member, must be obtained.

The 3rd and 6th floors of the hospital are locked/secured units for brain injured patients who can walk but have cognitive and memory deficits. Secured units help keep patients from wandering. You can visit the unit but will need a nurse or authorized personnel to let you out of the unit.

TIRR is located near a busy Level 1 Trauma Center (Emergency Room). Everyone should be aware of their surroundings.

There are a limited number of private rooms in our facility that are assigned based on diagnosis and medical necessity. Certain circumstances, such as the need for isolation, require a private room and will take precedence when room assignments are made.

Most patients are ready for inpatient rehabilitation when their medical conditions have been fully diagnosed, their medical status has been deemed stable and their acute medical issues are resolving. The patient needs to have the ability to tolerate three hours of therapy, at least five days per week, as well as the ability to willingly and actively participate. Patients with a condition or treatment that interferes with the ability to participate in therapy may require a stay at another level of care before coming to TIRR Memorial Hermann.

Our nurse liaisons will gather all pertinent information about a patient, including medical and functional status, to determine admission appropriateness. This information will be reviewed by a rehabilitation physician, or a designee, to determine acceptance into one of our inpatient programs.

The patient needs:

• Loose clothing that is easy to put on, such as sweat pants and T-shirts.
• Depending on the therapy goals, the patient may need something with buttons, but normally pull-over shirts and elastic pants are most appropriate.
• Shoes that don’t slip or slide; tennis shoes are encouraged. It may be necessary to provide one size larger due to swelling in the feet, which is common after injury.
• Undergarments (bras, socks, underwear)
• Toiletries (toothbrush, hairbrush, personal grooming products, etc.)
• As much as possible, we encourage items from home that represent a person’s personality prior to injury. It may not be necessary to purchase many new items.
• The above items allow us to appreciate the value of physical appearance to a person’s dignity. It is important to us to allow a person to change out of a hospital gown during the daytime hours – as often as medically-able. This is one step to restoring a person’s sense of wellbeing after injury.

• Do not bring large sums of money, jewelry or valuables.
• Razors, until discussed with therapist.

Laundry facilities are available on site on units 3-C and 5 for patient and family use. We cannot guarantee the availability of our staff to do a patient’s personal laundry, but the patient, family or caregivers are welcome to use the washers and dryers free of charge. We do ask that you provide your own laundry detergent.

Health transition planning starts before admission in order to help focus goals toward the best plan for treatment.

The interdisciplinary care team will make recommendations for health transition based on the patient’s medical needs and level of functional ability. Recommendations will be made in a way that encourages the patient’s functional independence in the least restrictive setting possible, while keeping in mind patient safety and caregiver burden. Our Case Management and Social Work staff will assist with coordinating any post-health transition needs to ensure a seamless transition to the next level of care. We assist with arranging physician follow-up appointments and will coordinate any special equipment needs that you may have as well. If indicated, you may follow up with your TIRR Memorial Hermann physician after health transition in the TIRR Memorial Hermann Outpatient Medical Clinic.