Toronto Rehab’s Complex Continuing Care Program (CCC) provides highly specialized care for adults with physical and/or cognitive conditions that limit their ability to move to the next phase of their recovery, or, to live independently in the community.

We offer patients:

• 24-7 care provision by registered nurses and registered practical nurses; and access to interprofessional team members
• Access to medical care through attending physicians
• Onsite access to medical specialists
• Semi-private and private rooms for patients with additional coverage;
• Evening and weekend activities;
• On-site services for patients requiring augmentative and alternative communication devices, chiropody and dentistry;
• Linkages to services and specialists in Toronto Rehab’s Spinal Cord Rehabilitation and Neuro Rehabilitation programs.

Our Wellness Philosophy guides all aspects of care and is based on the individual physical, spiritual and emotional needs of patients. Each patient and family member is considered an integral member of their interdisciplinary health care team and they are encouraged to participate in the development of their health care plan.

Housed in Toronto Rehab’s 224-bed E.W. Bickle Centre for Complex Continuing Care (formerly Queen Elizabeth Centre), CCC offers 176 beds dedicated to the care of individuals who require Complex Medical Services, and 48 beds dedicated to Low Tolerance Long Duration (LTLD) rehabilitation.

Contact

Toronto Rehabilitation Institute
Complex Continuing Care Program
E.W. Bickle Centre for Complex Continuing Care (formerly Queen Elizabeth Centre)
130 Dunn Avenue
Toronto, Ontario
M6K 2R7

For more information, or to arrange for a tour of the E.W. Bickle Centre for Complex Continuing Care, please call Michelle Mahovlich, Admissions Representative at 416-597-3422, ext. 2504. To make a referral, please complete the standard OHA referral forms for Complex Continuing Care and fax to 416-530-2470.

Complex Medical Services (Inpatient)

Complex Medical Services are provided for people with complex chronic and often fluctuating physical conditions such as complex chronic illness, end stage renal failure, multi-system decline, diabetes, and/or advanced degenerative disorders such as multiple sclerosis. Our services include:

• Complex Medical Services
• Dialysis
• Special Care
• Palliative care
• Respite care is also available.

Admission Criteria

Complex Medical Services:

• Clinically complex patients requiring regular nursing and medical intervention
• May require management of complex airway, medication administration including parenteral therapies, pain and symptom management, neurogenic bowel and bladder, seating intervention, complex wound management
• Advanced physical and/or cognitive challenges that limit or impair independent living in the community or in long-term care
• No requirement for a secured unit
• Levels of verbal and physical aggression will be assessed on an individual basis

Dialysis (12 beds):

• Same as Complex Medical Services, excluding tracheotomies
• Patients receive dialysis three times a week at Toronto Rehab’s University Centre

Special Care (26-bed unit):

• Same as Complex Medical Services
• Must be in a semi-comatose or comatose state, or must require respiratory support such as tracheotomy care and/or frequent suctioning
• May require continuous oxygen

Palliative Care (10-bed unit):

• 18+ years of age
• Diagnosis of an end-of-life illness
• Life expectancy of three months or less
• Difficulty with pain management that requires symptom relief
• Covered by the provincial health plan

Respite Care (2 beds):

• Same as Complex Medical Services
• Patients can be taken on a self referral basis
• Service is contract based and dates for admission and discharge must be pre-arranged well in advance
• There is a fee for this service

To make a referral, complete the standard OHA referral form for CCC and fax to 416-530-2470.

Low Tolerance Long Duration (LTLD) rehabilitation is provided for individuals impacted by neurological injury or illness or by a complicated medical illness, surgical procedure or trauma. It involves a longer course of rehabilitation than traditional active rehabilitation programs, with shorter periods of time spent in therapy each day.

Admission Criteria for all LTLD Streams:

• 18+ years of age
• Medically stable
• Demonstrates functional improvement or potential to increase function
• Requires less intense, long duration rehab
• Weight-bearing status assessed on case by case basis
• Demonstrates ability for new learning
• Able to follow simple visual/verbal commands
• Ability to participate actively in therapy is not precluded by behavioural symptoms.
• Able to tolerate 30 minutes of therapy daily
• Sitting tolerance of one (1) hour daily out of bed
• Goals for rehab and discharge plans have been established
• Post-rehab discharge destination is included on application

Admission Criteria for specific LTLD streams:

Neuro-Physical Stream (28 beds):

Typical diagnoses include ABI, CVA, spinal cord injury, degenerative disorders such as MS

• Demonstrates willingness and motivation to actively participate in rehab program (exception: patients with reduced motivation/initiation secondary to diagnosis (i.e. brain injury)
• Minimum Ranchos Los Amigos Score of 4
• Does not demonstrate disruptive, resistive or aggressive behaviours that will interfere with rehabilitation and their ability to be discharged to an appropriate destination or put their safety at risk.

Neuro-Coginitive Stream (10 beds):

Typical diagnoses include ABI, CVA, degenerative disorders such as MS, some types of dementia

• Demonstrates willingness and motivation to actively participate in rehab program (exception: patients with reduced motivation/initiation secondary to diagnosis (i.e. brain injury)
• Minimum Ranchos Los Amigos Score of 3, maximum score of 5
• May demonstrate mild to moderate disruptive, resistive or aggressive behaviours that will not interfere with rehabilitation, and their ability to be discharged to appropriate destination or put their safety at risk

Functional Enhancement Stream (10 beds):

Demonstrates recent physical deterioration due to acute illness or injury

• Demonstrates willingness and motivation to actively participate in rehab program
• Does not demonstrate disruptive, resistive or aggressive behaviours that will interfere with rehabilitation and their ability to be discharged to an appropriate destination or put their safety at risk

To make a referreal, complete the standard OHA referral forms for CCC and fax to 416-530-2470.