An unyielding passion for rehab care in rural communities

Rachel Sankey

Past Staff

September 9, 2024

CLEVELAND – Since 2019, the mission of ClearSky Health – a rehabilitative healthcare provider based in New Mexico – has been to take care of the rehabilitation needs of small, rural communities, Darby Brockette, CEO of the organization, said. 

And, for the new hospital being built in Cleveland (7929 North Ave.), Brockette said it’s no different.

“We recognize that there are areas of the country, or small communities, that don’t have rehabilitation care – that patients (who have) fallen, or had a stroke, or a car accident, head injury, spinal cord injury or orthopedic disorders – have to travel,” he said. “I’m familiar with small towns personally, and as we discussed what we could do as providers, it was clear that we wanted to serve those small communities where people have to go into the city.”

Traveling to larger cities for care, Brockette said, not only affects the patients, but their spouses and/or caregivers. 

“Seventy percent or so of our patients are on Medicare – so by definition, elderly,” he said. “Having seen that and in our lives, personally, where the spouse or caregiver has to go into the city, usually go to a hotel, eat out every night and friends aren’t able to come (is difficult).”

As the team at ClearSky thought about what healing meant, Brockette said they realized having friends and family nearby and being able to stay close to home helps with the healing process for patients.

“That’s how we had the vision for small communities,” he said. “You can look at our portfolio, (our hospitals) are all in places where people, historically, have had to go into the city for that level of care – or, even worse, didn’t get it – which caused them to go home or other places and then be readmitted to the acute care hospital. That’s trying on everybody and doesn’t work real well. Also, the fastest way to get better is through rehab.”

That’s why, when the team at ClearSky Health saw a need for a rehabilitation hospital in the Lakeshore area, Brockette said they got to work to help the community.

Boots on the ground

When it came to choosing Cleveland as an area that could benefit from a rehabilitation hospital, Brockette said the idea came from a mix of receiving calls from people, and Andy Rosen – the senior vice president of development of the organization.

“His job is looking at the demographics of places around the county,” he said. “But not only that, (we need to) meet the population criteria, X number of people, and also track discharges from the acute care hospital – where do people go?”

Brockette said the team looked at both Manitowoc and Sheboygan – and “fell in love with the area.”

“We looked at land in both of those markets, but we really needed the volume from both communities to make a business decision,” she said. “Cleveland is right in the middle (of them).”

From there, Brockette said, it was boots on the ground to retrieve the anecdotal evidence needed to open the hospital.

“We talked to caregivers and community leaders,” he said. “We even just talked to people in restaurants and bars, saying, ‘if there was a rehab (facility), would you go to Cleveland?’ It was literally that simple – extremely scientific on the front end, but more anecdotal on the back end.”

The response, Brockette said, was great – which meant the next step was talking to people in the village, the college and the hospitals.

“The university is producing therapists and nurses, so the idea came up as well – is not only a (place) for internships, but a (place) where people could work and grow in the Cleveland area,” he said. 

Everyone the ClearSky team talked to, Brockette said, embraced them – “there were lots of people from the community that were just all in.”

The final steps before the groundbreaking, Brockette said, included finding land, submitting a rezoning request and receiving lending from the bank.

Last month’s groundbreaking, he said, was the final step – now construction is underway.

A peek inside

Within the last five years, Brockette said ClearSky has built 15 hospitals across the country.

This meant when it came to designing the Cleveland hospital, the team had the processes down pat. 

“It’s almost the same design for all of our hospitals,” he said. “We sat down with nurses, and therapists and physicians, with our architect, and said, ‘okay, let’s design what would be the perfect, small rehab hospital.’”

To make the layout efficient for nurses, Brockette said they designed a central location for the nursing station, and then four wings going out.

The gym, he said, is the largest room in the hospital.

“One thing that we like and appreciate is nature,” he said. “So all the patient rooms have windows, and the gym faces the prettiest view.” 

The hospital will also have a cafeteria, but one that, Brockette said, will provide a different experience for patients than maybe what they’re used to in acute care hospitals.

“Our patients get dressed in the morning in real clothes and get up and eat in the cafeteria,” he said. “It’s not a tray (of food) like in a traditional hospital. We want people to get up and get around. (They) go to therapy three hours a day, which is tough on somebody that’s maybe elderly or weak, so the cafeteria is a central place (in addition to the gym).”

Another unique aspect of the hospital, Brockette said, is the room dedicated to patients and their loved ones/caretakers as they prepare to be discharged from the hospital.

“It’s set up like a normal room – a normal bathroom like at home, a bathtub, sink – and it has a kitchen in there (and) a regular bed, not a hospital bed,” he said. “It’s like an efficient apartment.”

Patients and – in most cases – their spouses, Brockette said, can stay in the room for a night or two to practice what it will be like for the both of them before returning home. 

“That’s what we do, I mean, occupational therapy (OT) deals with things that we are known for in rehab – dressing, and cooking,” he said. “We have speech therapy and physical therapy for walking. That last night is an indicator, but it’s also part of the education for the caregiver.”

In addition to the shared, larger spaces, Cleveland hospital will have 36 private rooms, which Brockette said is estimated to treat about 650 patients annually.

ClearSky broke ground on the Cleveland location last month.

If the weather cooperates, Brockette said the facility is estimated to be completed in the next 10-11 months.

“Danny Banks, who is our head of design and construction… (is) pretty good about getting the foundation down before winter, and getting the roof on so we can work in all-weather conditions,” he said. “They were laying steel during our groundbreaking… If they can get that in, then we can build through the winter.”

The rehab process

On average, Brockette said patients typically are discharged after 12-14 days from first coming to the hospital.

Within the first 24 hours of arrival, he said the patient is assessed by nursing physicians, specialized physicians and all the different therapists – “so we know a baseline and metrically where they are.”

From there, the team assesses and creates a treatment plan for the patient. 

“The team gets together and says, ‘okay, we need an hour of speech, an hour of OT and physical therapy,’” he said. “That happens in the first few hours of the stay.”

Throughout the patient’s stay, Brockette said the team discusses where the patient is at and establishes a projected discharge date.

“Then in the last couple of days of treatment, we assess all those things again, so we know how much the patient has improved,” he said. “That’s where we really shine, because we strive for the best outcomes, and of course, patient satisfaction.”

ClearSky treats patients who have had strokes, brain injuries, hip fractures, spinal injuries, Parkinson’s disease, multiple sclerosis or other medically-complex conditions, Brockette said. 

Typically, he said about 80% of patients are discharged to go home at the end of their stay.

The other 20%, he said, may go into a skilled nursing facility, senior housing or other similar institutions. 

“I’ve always used the analogy – we want you to go back to playing golf, or bridge, or whatever you were doing before – such as going to church and doing your own shopping,” he said. “That’s our ultimate goal. Some people can, some people can’t. Honestly, some people don’t want to. But most people want to go home.”

Passionate care, every time

Brockette said it’s important to note that the entire ClearSky team is spirited when it comes to providing rural communities with the care and attention they deserve. 

“When we build a hospital, that level of care is not there (in the area currently),” he said. “We’re passionate – I mean passionate – about that level of care.”

Every day at each of the ClearSky Health hospitals, Brockette said, “there’s a miracle.”

“Because somebody walks, or talks or eats,” he said. “It’s just a miracle.”

Not only is it crucial to bring the best rehabilitation care they can to the area, Brockette said it also brings in more opportunities for people to live and work in the community.

“We’ll have more than 100 people (on staff) when we’re fully completed,” he said. “And being close to the college there is perfect. The economic impact of having that many more jobs.”

It’s also important for ClearSky to be involved in the communities it serves. 

“Our management teams and others participate in things in the community,” he said. “Fun drives for United Way, and all those things. We’re a part of the community, and we’re giving back to the community as well.”

To learn more about ClearSky Health, visit clearskyhealth.com.