While on a summer walk Mary Williamson suffered an evolving stroke. Following days of medical care, she was lucky, she says, to receive physical therapy at the inpatient rehabilitation unit at Logan Health Medical Center.  

Entering the facility in a wheelchair and unable to use the left side of her body, when she was released, into the care of her husband, a former physician, she was in much better health. But had it not been for the inpatient physical therapy she says her life would look much different.  

“The fact that I had that resource is a huge reason why I feel like I have a life worth living,” Williamson said through tears. 

Logan Health is closing its inpatient rehabilitation facility in February with plans to turn the facility into a surgical unit. It’s a decision hospital Co-CEO Kevin Abell announced at the beginning of December in an email to staff.  

“The demand for inpatient medical [and] surgical beds has increased while admissions to the inpatient rehabilitation unit have steadily declined over the past few years, primarily due to insurance coverage limitations, complex prior authorization processes and more stringent eligibility requirements,” Abel said. 

The inpatient rehabilitation unit treats stroke, traumatic brain injury, orthopedic, spinal cord injury, amputation and cardiac patients. Individuals have a minimum of three hours of therapy five days per week.  

To be designated as an official inpatient rehabilitation center, there must be 10 beds reserved for rehabilitation use, according to the hospital’s Chief Medical Officer Dr. Cory Short. On average last year, 4.7 beds were used in the unit and in September that number was 3.8. Meaning that roughly five to seven beds were unused at any given moment, according to the hospital. 

In recent years, Logan Health has had to turn away medical and surgical patients or place them in the emergency room. This year, 275 patient transfers were denied due to a lack of medical and surgical capacity.  

The goal, Short said, is to turn the 10 rehab beds into surgical beds — and add three more — to cater to the area of increased demand. 

An additional factor in the decision, according to the hospital, is the planned retirement in April of the facility’s medical director Dr. Mark Weber.  

Short said he emphasizes with those who are disappointed in the decision but points out that with challenges in health care including finite resources changes can be necessary.  

“It’s never an easy decision by any stretch of the imagination,” Short said.    

Conversation is ongoing about relocating nurses and doctors in the unit, if possible, once it does close, according to Short.  

The facility is one of four acute rehabilitation centers in Montana. The others are in Great Falls, Missoula and Billings Clinic, which merged with Logan Health in 2023. Short said that the merger did not impact the decision. 

MARY OPALKA has worked on the unit for 18 years. The announcement of closure, she said, was a total shock. 

“I really lost it, I immediately just started crying and upset because of the impact that it is going to create for the community,” Opalka said. “Unfortunately, there was not a heads up for this or no knowledge that this coming down the pipe.”   

Short said that discussions about closing the unit have been going on since September. 

The patients in the rehab facility are people who could qualify for inpatient rehabilitation, Opalka points out, but now will have to be transferred to another facility or use an external service that isn’t as intensive.  “The biggest loss is going to be losing a service that really cannot be replicated at a lower level of care. You don’t have the team approach. You don’t have the three hours of therapy a day at a skilled facility,” Opalka said. “These patients are not going to get that really good therapy and nursing to be able to go home within a reasonable amount of time.”   

The unit has little employee turnover, Opalka said, and has maintained a team approach to changing someone’s reality after a tragedy. 

“All nurses make a difference, but rehabilitation nurses make a difference in quality of a patient's life,” Opalka said. “We made a difference here in this rehab. We have a lot of patients and families calling us upset about this. All of us have been here a long time. We are all really passionate about it.” 

A former patient, John Peine, is disappointed by the news of the closure. He went into the rehabilitation unit in 2021 after suffering from a Covid-19 illness that left him in an induced coma. When he woke, he was unable to move, and the rehabilitation unit helped him relearn how to hold his own body weight, talk and swallow again.  

“That’s why I feel very strongly about this because I honestly think it's those people in rehab that made me go in the direction I did. It would have been so easy for me to just give up and say I can’t move, but they gave me drive,” he said.  

Peine and his wife live in Kila with their six dogs. Leaving the area for care would not have been feasible for him or his family.  

“Coming from somebody who needed it and never thought they would need it ever, it never crossed my mind, and I never realized how important it was to you until it happens to you. And for that service not to be there it's going to hurt our community bad,” Peine said. 

For patients who have benefited from the rehabilitation unit, the news is a blow as it truly changes lives, Williamson said.  

“They made it possible for me to be possible to be discharged to home. I’m confident I’d be in a skilled nursing facility still if they hadn’t been able to arrange that,” she said. 

The unit officially closes on Feb. 3. 

Reporter Kate Heston may be reached at 758-4459 or [email protected].