kp.org

Member and Marketing Communications5518-0686-01-r03

“She was right there

with me the whole time.

She gave me information.

She gave me choices.”

—Elaine Granados on

Dr. Colleen Wittenberg

For Elaine Granados, a normal conception was a miracle. She had been prepared to have problems conceiving because of a previous ectopic pregnancy. “But before I knew it,” she exclaims, “I got pregnant!”

Then, just weeks into her pregnancy, Elaine started spotting. She rushed to the emergency department at Kaiser Permanente Riverside Medical Center, where doctors found a mass protruding from her cervix. Was she miscarrying? Colleen Wittenberg, MD, chief of obstetrics and gynecology, came to examine the worried mother-to-be. Amid the bustle of the emergency room, Dr. Wittenberg found a tiny heartbeat.

Elaine followed up with Dr. Wittenberg for a biopsy, which revealed that the mass was a large polyp that was forcing her cervix to dilate. Dr. Wittenberg believed that Elaine had a 25 percent chance of losing the baby if they removed the polyp. But without surgery, the chance of miscarriage doubled.

Worried about the risk that surgery would place on the baby and Elaine, her family advised her against it. “But I trusted in Dr. Wittenberg,” explains Elaine. “I went with my gut feeling and followed her recommendations. Thank God they were the right ones.”

After recovering from the surgery, Elaine developed weakness in her cervix, which posed another threat of miscarriage. Dr. Wittenberg put a stitch around Elaine’s cervix and monitored her closely, seeing Elaine twice a week until she was ready to deliver.

On the morning of the delivery, Dr. Wittenberg removed the suture and per- formed the delivery herself. “It was great that Dr. Wittenberg was there to deliver my baby,” says Elaine. “She was there from the beginning. I wouldn’t have wanted any other doctor.”

Elaine sums up the whole experience this way: “I felt blessed to have Kaiser Permanente.”

Today Elaine, Marissa, and proud papa David are all doing fine. Marissa, now 2 ½, has the passions of any little girl her age: crayons, playing in the pool, and SpongeBob SquarePants.

Marissa is a little smaller than other kids her age, but that doesn’t worry Elaine and David. “We’re not worried about her being petite because she has this attitude where she gets her way,” Elaine explains. “She’s like a little dog with a big bite.”

And there’s one other thing about Marissa that both parents agree on: “We can’t imagine life without her.”

BUILDING A FAMILY ON A FOUNDATION OF TRUST.

Developing a close relationship with her Kaiser Permanente physician delivered hope and a healthy baby to a first-time mother.

Kaiser PermanenteThe Center for Reproductive Health

The next step

Many Kaiser Permanente members have coverage for

the diagnosis and treatment of infertility, and some

members have coverage for in vitro fertilization (IVF)

procedures if IVF is listed as a covered benefit in the

Evidence of Coverage for their Kaiser Permanente

health benefit plan. Otherwise, the services described

in this brochure are provided on a fee-for-service

basis, separate from and not covered under your

health plan benefits. Clinical services are provided

by providers or contractors of The Permanente

Medical Group, Inc. Kaiser Foundation Health Plan,

Inc., and Kaiser Foundation Hospitals may receive

compensation for providing facilities and/or other

support in connection with these services. For specific

information about your health plan benefits, please

see your Evidence of Coverage.

Photos of models shown, not actual patients.

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You want to start a family, but it hasn’t been

easy. When you’re looking for a solution,

it’s good to be on familiar ground. Choosing

Kaiser Permanente for your in vitro fertilization

(IVF) is one of the best decisions you can make.

Kaiser Permanente has been taking care

of Californians for 60 years. The Center for

Reproductive Health in Fremont offers IVF

services as well as an egg donor program.

We offer advanced, innovative equipment and

technology, and we’re staffed with excellent

doctors and scientists in the field. Every step

of the way, your personal infertility doctor will

be involved, and your records will be accessible

and secure. So when you choose us for your

IVF, you can count on high-quality medicine,

coordinated care, and peace of mind.

In vitro fertilization.Take the next step with

someone you know. And someone who

knows you.

In vitro fertilization and egg donor program

Location:The Center for Reproductive Health

Fremont Medical Center

39141 Civic Center Drive

3rd Floor, Suite 350

Fremont, CA 94538

Hours:

Monday–Friday, 8 a.m. to 5 p.m.

Saturday–Sunday, by appointment only

Telephone:

510-248-6900

1-888-886-0079 (toll free)

Online: www.kpivf.org

What is “in vitro ferti l ization”?In vitro fertilization (IVF) is the process of combining a woman’s egg

and a man’s sperm outside the body, in a laboratory. An embryo forms

in the laboratory, and after a few days, it’s placed in the woman’s uterus.

What you can expect: The IVF cycle has three phases.

Phase 1: IVF Fertility Evaluation of the Couple and Stimulation of the Woman’s Ovaries with Fertility Drugs

The fertility of both the

male and female partners

is evaluated. To increase egg

production, the woman’s

ovaries are stimulated with

hormone injections, and egg

development is monitored

through ultrasound scans and

blood tests. At the appropriate

time, ovulation is triggered with

an HCG hormone injection.

Your teamKaiser Permanente’s reputation for excellence

attracts some of the most qualified physicians

in the nation, and so we’ve assembled a team

of excellent doctors. Our doctors practice

together as a group, each focusing on his or

her specialty, while consulting with trusted

peers when necessary. They are dedicated to

helping you achieve your dream of parenthood

by providing personalized care in a supportive

and caring atmosphere.

Quality medicine. Coordinated care. And peace

of mind. That’s what you expect from Kaiser

Permanente for all your other health needs.

And that’s what you can count on for your IVF.

To learn moreFor more information about IVF or the egg donor

program, please call 1-888-886-0079 or visit us

online at www.kpivf.org.

Phase 2:Egg Retrieval, Fertilization, and Embryo Transfer

Eggs are retrieved directly

from the ovaries using an

ultrasound-guided needle.

The eggs are then placed

together with sperm in a

special culture. If fertilization

occurs, the embryos develop

in an incubator over several

days before the woman

returns to The Center for

embryo transfer.

Phase 3:Follow-up Care

We’ll determine if pregnancy

has occurred and then plan

for additional follow-up care.

Your cost: Single-cycle plan pricing

You are charged one fee for an IVF procedure, which

typically includes the following:

• Anesthesia

• Cycle monitoring

• Egg retrieval

• Embryo culture

• Embryo cryopreservation and storage for up to six months

• Embryo transfer

• Facility fee

• Lab tests

• Medication*

• Sperm preparation

• Ultrasounds

The single-cycle plan fee does not include the following:

• Assisted hatching

• Intracytoplasmic Sperm Injection (ICSI)

• Reproductive urologic procedures

• Preimplantation Genetic Diagnosis (PGD)

• Frozen embryo transfer

• Donor eggs or sperm

Egg donor programThe egg donor program provides an integral option for

treating women with infertility who otherwise would not

be able to conceive on their own. We assist patients in

the donor selection process, coordinate all screening

and cycle monitoring for both donor and recipient,

and provide education and support throughout the

process. Our experienced staff will guide both the

donor and recipient every step of the way.

*Your infertility physician may increase or change your medications or dosage which may increase the IVF medication fee. Medication fee based on Kaiser Permanente membership status.

Financing is available.

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LIVINGWHOLEWELL& WISE

AN EVENT CELEBRATING EVERYDAY HEALTH FOR WOMEN AND GIRLS

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speakers

ALICE WATERS NATALIE COUGHLINLEE BALANCE, MD JENNIFER CHERRY TERRY FRANKLIN, RD

SARA GOTTFREID, MD KELLY HOOD, MD VIVIAN IGRA, MD

DEBBIE POSTLETHWAITE, RNP, MPH SHERRY PRUITT, PhD

MARCELLA RAIMONDO, MPH SABINE VON GLINSKI, MD JANE WIRTH

ALICE WATERS

Alice opened Chez Panisse in 1971, with the philoso-phy of serving only the highest quality products, only when they are in season. Over the course of three decades, Chez Panisse has developed a net-work of mostly local farmers and ranchers whose dedication to sustainable agriculture assures Chez

Panisse a steady supply of pure and fresh ingredients.

In 1996, in celebration of the restaurant’s twenty-fifth anniversary, she created the Chez Panisse Foundation to help underwrite cultural and edu-cational programs such as the one at the Edible Schoolyard that demon-strate the transformative power of growing, cooking, and sharing food.

Alice is author and coauthor of eight books, and the recipient of numer-ous awards, including Bon Appetit magazine’s Lifetime Achievement Award in 2000 and the James Beard Humanitarian Award in 1997.

NATALIE COUGHLIN

Natalie Coughlin has built a reputation as the most versatile, dominant swimmer in the world. She seized five medals at the 2004 Olympic Games in Athens-two gold, two silver, and one bronze. Natalie's performance is considered the best in

Olympic history by any American woman.

In doing so, Natalie became only the third American woman to win five swimming medals in a single Olympics. Natalie has broken mul-tiple world records in the 100 m backstroke, is the current world record holder, and still remains the only woman ever to swim this event under the one minute mark. Overall, Natalie has broken six world records, 34 American records and 11 University of California, Berkeley records.

Currently, Natalie has her sights set on the 2008 Olympics in Beijing. She was recently selected as the 2005 National Spokesperson for “Kick Butts Day,” a youth-focused, coast-to-coast event put on by the Campaign for Tobacco-Free Kids.

JENNIFER CHERRY, PRIVATE FITNESS COACH

Jennifer Cherry owns and operates Fit Image Consulting in Alameda. Sheis an ACE certified Private Fitness Coach and Master Fitness by Phone Coach®.

She entered the fitness industry in 1989 with a background in ballet and competitive ice-skating. Jennifer helps her clients achieve their fitness goals by developing realistic programs that are manageable and effective. Her innovative approach is what makes her one of the most successful fitness coaches in the Bay Area.

Lifestyle Exercise: How to Find the Time and Stick to It! We all know the importance of exercise in creating a balance of physi-cal and mental health. Yet, reaching personal fitness goals can be challenging, especially when exercise can seem like another chore in an already hectic schedule. Can exercise really be fun and life-style friendly? Yes! Personal fitness trainer Jennifer Cherry knows the perils of personally peeling pounds. She'll show you how to lose weight, keep it off, and prevent adding those pounds in the first place. Let her motivate and educate you to choose the kinds of exer-cises that fit both your body and your schedule for fitness success.

LEE BALANCE, MD

Dr. Balance attended the University of Chicago (now Pritzker) Medical School after graduating from Michigan State University. Following medical school, he completed an internal medicine training program at Lincoln Hospital in the South Bronx.

After three years of private practice in western Massachusetts, he moved to northern California and began working in emergency rooms. For the next several years, while continuing his emergency room work, he pursued training in many alternative medicine, includ-ing acupuncture, acupressure, hypnosis, and meditation. He joined Kaiser Permanente in 1988, working first in the Hayward Emergency Department then transferring to the Vallejo Medical Center, where he continues to work in the Orthopedic Department and serves as Chief of Alternative Medicine and Continuing Medical Education. He is board certified by the American Board of Internal Medicine and the American Board of Emergency Medicine. He received his medical acupuncture training through UCLA and is a member of the American Academy of Medical Acupuncture. When not at work he enjoys out-door activities, including bicycling and water sports.

Complementary and Alternative Medicine (CAM) in the Early 21st Century. CAM is often used to improve quality of life and manage various medical conditions. Dr. Lee Balance answers some very important questions such as “Does acupuncture really work, and if so, for what?” and “Should I use St. John’s wort when I am feeling down?” Many people think that because CAM is natural, it must be safe. However, anything that has possible benefits also has possible adverse effects. Attend this informative workshop and learn about the different types of CAM, its safety and effectiveness, and its potential to interact with other treatment methods.

SABINE VON GLINSKI, MD

Dr. Sabine von Glinski was born in Munich, Germany, and grew up speaking German as her first and familial language. Most of her child-hood was spent in the mountains outside of Golden, Colorado. Prior to attending college in the United States, she studied in France and obtained her baccalaureate from a lycee just outside of Paris.

Her undergraduate education was in physics with a degree from the University of California, Berkeley. She had intended to pursue an interest in magnetospheric and ionospheric physics, but fortunately remained a bit more earthbound and ended up pursuing a degree in medicine from the University of Colorado at Denver. Further training in orthopedics included clinical research with numerous publications in the field of joint arthroplasty or replacement at the University of Utah, an orthopedic residency with the San Francisco Orthopedic Residency Program, and a fellowship in trauma orthopedics in Hanover and Berlin, Germany, through the organization AO North America.

Prevention of Sports Injuries and Injuries of Daily Life. Athlete and orthopedic surgeon, Dr. Sabine von Glinski will share tips on the best ways to prevent injuries during physical activity. She will also discuss strategies for recovery from sports-related injuries and surgeries. Whether you run, bike, swim, shoot hoops with your fam-ily, or tote babies or briefcases, learn how to perform any activity safely; and recover quickly when you don't. Come with your ques-tions and talk with this expert about the preventions and treat-ments for maximizing performance, reducing fatigue and improving ergonomics—at any age.

TERRI FRANKLIN, RD

Terri Franklin is a registered dietitian at the Kaiser Permanente Walnut Creek Medical Center, where she instructs individual members on special nutritional needs and teaches cholesterol, diabetes, heart smart, and healthy kidney classes.

She received her BS degree in foods and nutrition at California State Polytechnic University in Pomona, California, and completed her dietetic internship at University of California, San Francisco Medical Center. She has a CDR (Commission on Dietetic Registration) certifica-tion and food safety certification. Her hobbies include water aerobics and Pilates, old movies, and reading.

Healthy Eating: The Skinny on Popular Diets. Is the South Beach Diet really today’s healthiest carb diet? Does Atkins allow you to eat satisfying amounts of delicious, nutrient-dense foods and still drop pounds? With dieting products and plans everywhere in the media, how do you separate fact from fallacy? Nutrition expert and registered dietitian Terri Franklin gives you the straight scoop on these popular diets and the effects of dieting in general. Learn about successful weight loss and management strategies for a healthy lifestyle. Find out how eating the right foods—and avoid-ing others—helps us live whole, well, and wise.

KELLY HOOD, MD

Kelly Hood, MD, has been practicing medicine for 12 years and joined Kaiser Permanente in 2002. She is board certified by the American Academy of Dermatology. Dr. Hood received her medical degree from Louisiana State University and completed a residency program at Tulane University Medical Center.

She is a member of the American Academy of Dermatology, the American Society of Dermatologic Surgery, and the San Francisco Dermatology Society. She is also a spokesperson for the American Academy of Dermatology.

Dr. Hood is passionate about women's health and education, and has always enjoyed cutting-edge cosmetic and general dermatology. When she is not working, she enjoys spending time with her husband and twin sons.

Take Care of the Skin You Are In. Your skin is the largest organ of your body. Keeping facial skin beautiful means sorting through more choices in the marketplace than ever before. Botox®, facial peels, anti-wrinkle creams and others—how do you navigate the latest advances in plastic surgery and dermatology? From options to best choices, what works and what hurts, how much and how often, talk to an expert about the latest cosmetic procedures to decide what’s safe and effective for your skin. Dermatologist and surgeon Kelly Hood will also show you nonsurgical ways to care for your skin and make it look its best as it undergoes many changes throughout life.

SARA GOTTFRIED, MD, RYT

Sara Gottfried, MD, RYT, learned yoga first from her great-grandmother and began a daily practice in 1989 while at Harvard Medical School. She was drawn toward integrative medicine at Harvard and completed intensive seminars with Herb Benson, MD; Deepak Chopra, MD; David Eisenberg, MD; and Ted Kaptchuk, OMD.

Following medical school, Dr. Gottfried finished her training at the University of California, San Francisco, in Obstretics and Gynecology. She joined Women's Health at Kaiser Permanente in 1998 and prac-tices integrative medicine at the Park Shadelands Medical Offices in Walnut Creek, California. As a yogini, her practice is rooted in the Krishnamacharya lineage and draws upon the teachings of TKV Desikachar (Viniyoga), BKS Iyengar and Patricia Walden (Iyengar Yoga), and Ana Forrest (Forrest Yoga). A believer in adaptating yoga to the individual, she prescribes common yoga poses alongside western medicine to her patients. In 2003, she began teaching pre- and post-natal yoga as well as workshops in Berkeley, where she lives with her husband and two daughters.

Yoga. Certified yoga instructor Sara Gottfried teaches the ancient healing practice that affects our total well-being: physical, psy-chological, physiological, emotional, and spiritual. From the “om” breath to posturing, yoga rejuvenates the body while replenish-ing the spirit. This harmony makes yoga different from stretching. Who doesn’t want the benefits of improved lung respiration, blood circulation, muscle tone, flexibility, and mental focus? Practice this “movement meditation” that can put the ahh back in your physical alignment, and eases menstrual pains, anxiety, and depression. Get a yoga education, and be ready to try the demonstrations. There are no prerequisites for this class—you don't have to be able to touch your toes before you begin.

DEBBIE POSTLETHWHAITE, RNP, MPH

Debbie Postlethwhaite, RNP, MPH, is an Ob/Gyn nurse practitioner at Kaiser Permanente's South San Francisco Medical Center. She is also projects director of Women's Health Leadership in Northern California, and an investigator for the Kaiser Permanente Women's Health Research Institute.

Much of her work centers on developing effective strategies to reduce unintended pregnancies and their negative outcomes and on improv-ing preconception health. She enjoys running with biking with friends, and attending sports events with her son.

Protecting Future Generations. This workshop will briefly dis-cuss the most important steps you and your daughters can take, whether you are planning a pregnancy now, in ten years, or if you are unsure whether you want children at all. Simple things like taking a multivitamin containing folic acid can greatly reduce the chances for brain and spinal cord birth defects called neural tube defects. Planning a pregnancy by using effective birth control is also impor-tant to reduce the risk of birth defects. These and other important prevention topics for all women and girls of childbearing age will be discussed in this interactive session.

VIVIEN IGRA, MD

Vivien Igra, MD, is a pediatrician at the Kaiser Permanente Walnut Creek Medical Center. She has been practicing at Kaiser Permanente since 1994. She is a member of the American Academy of Pediatrics, American Medical Women’s Association, and Society for Adolescent Medicine. She received her medical degree from Finch University of Health Sciences/the Chicago Medical School, North Chicago, IL, and completed her residency at University of California, Davis Medical Center, in Sacramento. She has done a fellowship at University of California, San Francisco Medical Center, and is board certified in adolescent medicine by the American Board of Pediatrics.

MARCELLA RAIMONDO, MPH

Marcella Raimondo, MPH, is a senior health educator at Kaiser Permanente. Her passion about the serious issue of eating disorders and body image stems from her 10-year battle with anorexia. From her experiences with the disorder and her recovery, Marcella devel-oped a deep understanding, insight, and sensitivity about these issues. She is also the Media Literacy Director for About-Face, a San Francisco nonprofit that focuses on body image, eating disorders, and media. Ms. Raimondo received her Masters in Public Health from the University of Michigan in Ann Arbor. She interned at the Center for Eating Disorders, giving talks to schools and colleges in Ann Arbor and participated in eating disorder research.

Is it Really Just a Diet? In this supermodel world, how do you love the body you're in when the media bombards us with unrealistic images? Are the numbers on a scale reflective of your self-worth? Join us and get answers to questions you have about eating dis-orders. Learn how to cultivate a positive body image, and how to be a good role model for your daughters. Former anorexia nervosa sufferer Marcella Raimondo, MPH, and pediatrician Vivien Igra, MD, talk openly about how to recognize the signs of eating disorders, why weight gain is an integral part of pubertal growth, and how to maintain healthy self-esteem.

SHERI D. PRUITT, PhD

Sheri D. Pruitt, PhD, is a clinical psychologist and the Director of Behavioral Science Integration for Kaiser Permanente in Sacramento, California. Her work is at the organizational level, solving problems in the delivery of health care by applying behavioral science.

Dr. Pruitt has BS and MEd degrees from the University of Oklahoma and MS and PhD degrees from the University of New Mexico. She was a member of the faculty of the University of California, San Diego School of Medicine. As a scientist for the World Health Organization (WHO) in Geneva, Switzerland, she was the principal writer for two WHO reports providing global strategies for innovative care for chronic conditions. Dr. Pruitt has published extensively in the area of behavioral medicine, examining the influence of behavior on health outcomes. She is coauthor of a recently published book, Stop Telling Me What—Tell Me How.

It's All About You: A Healthy Body, A Happy Mind. Psychologist Sheri D. Pruitt, PhD, encourages us to remember the words of air-line flight attendants: “In case of an emergency, place the oxygen mask on yourself first!” When trying to balance the responsibilities of family, work, and relationships, a woman's tendency is to put her own needs last on the list. Sherry's simple, proven formula improves physical health and mental happiness. The keys are: knowing what to do, how to do it, and wanting it for yourself. You’ll leave this workshop with five “how-to” skills to change any unhealthy behav-ior—freeing you to enjoy the things in life you cherish most.

JANE WIRTH

Jane has worked in the field of Health Education for 25 years at Kaiser Permanente. She is a motivational speaker who has made presenta-tions for the community on healthy eating, heart health, weight management, stress management, and spiritual growth.

Jane has been certified as a Labyrinth Facilitator for seven years and received her training through the Veriditas labyrinth movement at Grace Cathedral, San Francisco. She facilitates labyrinth events and has taught at Chartres Cathedral in France. Jane and her husband Craig were featured in an article about labyrinth use in the August 2003 issue of Ladies’ Home Journal. Her personal interests include biking, hiking, bonsai training, music, and her grandchildren.

Walk Away Your Stress: Labyrinths for Relaxation. Merge spiri-tuality into your everyday life as motivational speaker and certified Labyrinth Facilitator Jane Wirth shows us how to use the imagery of a labyrinth to lessen stress. The labyrinth is an ancient symbol used as a meditation and prayer tool because it represents a journey to our own center and back again out into the world. The result-ing sense of purpose relieves stress. Walk the onsite labyrinth and experience wholeness and wellness on this spiritual journey to your inner self. Then take the journey home to share the experience with family and friends to better their health.

HOW TO MAKE THE MOST OF

YOUR STAYWhile you’re here in the Stroke Unit, we want to make sure that you get the best care possible. We also want to give you the information you need so you can know what to expect while you’re here.

YOUR HEALTH CARE TEAMYour team includes physicians, nurses, social workers, and physical, occupational, and speech therapists. You and your family can speak directly with any of them if you have questions or concerns. We hope you’ll join us in making decisions about your care. Please ask someone in your family to be your spokesperson to help share your progress to your family and friends.

WHILE YOU’RE HEREYour doctor and health care team will meet with you. They’ll explain your tests and treatments, and answer your questions. They may also tell you when you might be able to leave the hospital. They will develop a plan to help you recover as much function as you can. The plan will give steps to reduce your chance of having another stroke in the future.

First, we’ll run a number of tests. They may include:

• Checking your blood pressure, pulse, breathing rate, and temperature• A CT scan to identify the type of stroke you had and to see what part of your brain has been

affected • Chest X-rays• Test(s) to see how well you can swallow and to decide what types of solid food and liquid you

should have• Tests to see how well you can move, talk, see, read, write, and understand words• Exams to see how well your body can control your bladder and bowel functions• Tests to show how well you can dress and bathe yourself

Your treatments will depend on your condition and the results of your tests. They might include:

• Oxygen to help you breathe easier • Medications • Insertion of an intravenous (IV) line to administer drugs• Physical therapy to restore movement, strength, and function• Occupational therapy to help you get back to your regular activities at home and at work• Speech therapy to help you speak better and swallow

It’s also very important to talk with your family about your Advance Health Care Directive, a form that allows someone else to speak for you when you cannot. If you don’t have one yet, please fill one out. You can pick up the form in the Health Education Department at your medical center.

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GETTING READY TO LEAVE THE HOSPITAL Before you leave, you’ll meet with your health care team about:

• Any concerns you have about your plans to go home or to another type of medical facility

• Your medication(s) and possible side effects• Feelings or unexpected emotional reactions you might have• Special equipment you may need to help you move around• The best things for you to eat and drink• Balancing rest and activity• Stopping smoking (if you smoke)• Follow-up appointments with your physician and rehabilitation therapists (if required)• Community support groups. You can find them at senior centers, adult day care centers,

recreation centers, social services, churches, and synagogues. You can also check the Web sites of the American Heart Association (americanheart.org) and the American Stroke Association (strokeassociation.org).

The kind of therapy you need will guide where you will go after you leave the hospital. Early rehabilitation therapy is very important, and you may start therapy soon after you are admitted to the hospital. During your stay, your doctor will work with the therapists and other members of your team to decide on the right kind of therapy and the best place for your rehabilitation after you leave the hospital.

AFTER YOU LEAVE THE HOSPITALHome: If your doctor feels that you are medically stable and can function safely at home, you might be able to go home. You will be discharged with orders for home health services or outpatient therapy. Home health services are for patients who are homebound and can’t come to the medical center for regular appointments. (This does not include patients who simply lack transportation.) If you don’t qualify for home health services, you will get outpatient therapy in the Physical Therapy Department at either our Sacramento Medical Center or Roseville Medical Center, whichever is closer to you. Outpatient care is only for those who can manage safely at home alone, or have enough support from family, friends, or paid caregivers.

Skilled nursing facility (SNF): If you need nursing care and more intensive daily physical therapy, you might go to a skilled nursing facility. Our patient care coordinator (PCC) will help you find the one that’s right for you. You’ll receive all the therapies that you need right there. They will be geared toward your specific needs.

As you improve, your therapy needs will change. The staff at the skilled nursing facility will evaluate you on a regular basis and change your therapy as needed. Speech or occupational therapy will also be tailored for you if you need them. If you will be going to an acute rehabilitation center in the future, the skilled nursing facility will prepare you for the therapy regimen that it will require.

Acute rehabilitation center: If you need intensive therapy and can do a more difficult rehabilitation program for several hours each day, you might go to an acute rehabilitation hospital or center. You will receive at least three hours of therapy each day. Kaiser Permanente’s rehabilitation center is located in Vallejo.

The Stroke Information pamphlet you receive provides many details of managing your health. If you have any questions that aren’t covered in that pamphlet or this brochure, please talk to a member of your health care team.