Spinal Cord Injuries and Disorders System of Care

At the Richmond SCI/D Center, we provide acute rehabilitation and lifelong care for Veterans and active-duty service members with spinal cord injury and disorders affecting the spinal cord.

Our SCI/D Center was designed and dedicated specifically to serve the health care needs of people with SCI/D. We began operations in 1947 and we're currently one of the largest SCI/D Centers in VA. Our SCI/D Center is affiliated with Virginia Commonwealth University School of Medicine to provide learning and research opportunities to medical students, residents and fellows.

We serve eligible Active-Duty Service Members and Veterans with traumatic and non-traumatic spinal cord injuries and disorders (SCI/D) including Multiple Sclerosis (MS) and Amyotrophic Lateral Sclerosis (ALS). Richmond is a regional referral center that serves multiple Veterans Affairs Medical Centers across Virginia, North Carolina, South Carolina, Tennessee, West Virginia, Maryland, Delaware, Kentucky, and Washington D.C. We also receive patients from Department of Defense Medical Centers and private hospitals.

We have 68 beds for inpatients, and our outpatient clinics include both specialty and primary care treatments. We also have lodger beds for Veterans traveling longer distances.

We have parking dedicated for patients at the SCI/D Center at the front entrance of the SCI/D Center.

Our Center is staffed by interdisciplinary teams of experts who utilize a rehabilitation model of healthcare with a primary care focus. Our staff is strongly committed to providing lifelong, comprehensive, personalized care that extends from the hospital into your home and community.

In addition, we have a strong relationship with the Paralyzed Veterans of America (PVA). This allows us to work collaboratively to effectively care for our patients.

The Richmond VA SCI/D Center serves as a Hub Site for several affiliated VA health care systems (Spoke Sites) that do not have SCI/D Centers.

We work closely with spoke sites to provide coordinated care for Veterans affiliated with VA hospitals in Wilmington DE, Clarksburg WV, Baltimore MD, Martinsburg WV, Washington DC, Beckley WV, Durham NC, Fayetteville NC, Salem, VA, Salisbury, NC and Huntington WV.

Our Interdisciplinary team is dedicated to excellence in providing comprehensive, integrated rehabilitation and state of the art health care and treatment for Veterans with disorders of the spinal cord.

We work with Veterans and active-duty service members to meet their goals for healthy and fulfilling lifestyles. We assist by maximizing independence, increasing mobility, ensuring access to the community, preventing secondary medical conditions, assisting attainment of vocational pursuits, meeting athletic and recreational pursuits, and accomplishing their personalized goals.

Our program uses both rehabilitation and primary care models of health care with an emphasis on patient and family education, self-reliance, independence, and patient centered care.

The dedicated, interdisciplinary team works to provide a wide variety of services to Veterans and active-duty service members. Our high-quality staff have achieved high levels of expertise in SCI/D care. We care for Veterans through their entire lives by providing a variety of services:
- Acute rehabilitation
- Primary care
- Medical and surgical management
- Inpatient and outpatient wound care
- Ventilator management and weaning
- Respite care
- Comprehensive interdisciplinary annual evaluations
- Whole health programs
- Peer mentoring
- Community based activities

Our VA SCI/D Center has a very active research department where staff continually work to provide access to some of the most up-to-date and state of the art care in the world.

We are accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF).

If you have questions about care at the Richmond VA SCI/D Center or you want to find out about transferring a patient into the Center, please call us at 804-675-5455

We have a dedicated team of interdisciplinary providers to help you meet your goals every step of the way.

- Physicians
- Physician Assistants
- Nurse Practitioners
- Rehabilitation Nurses
- Physical Therapists
- Occupational Therapists
- Kinesiotherapists
- Recreational Therapists
- Social Workers
- Psychologists
- Vocational Rehabilitation Counselors
- Pharmacists
- Dieticians
- Chaplains
- Volunteer Peer Mentors
- Rehabilitation Engineers
- Administrative staff

The Richmond SCI/D Center, part of the Central Virginia VA Health Care System, is a CARF accredited rehabilitation facility. We offer both inpatient and outpatient patient-centered rehabilitation programs for Veterans and active-duty service members with injury or disorders of the spinal cord.

We have a patient-centered rehabilitation program which promotes early mobilization, maximizes functional independence, community reintegration, and stresses prevention of secondary complications. The acute rehabilitation care includes a comprehensive and intensive interdisciplinary team approach incorporating patient goals and utilizing the skills of multiple disciplines, e.g., physical therapy, occupational therapy, speech language pathology, rehabilitation nursing, psychology, respiratory therapy, recreation therapy, kinesiotherapy, pharmacy, nutrition services, other medical specialties.

The focus of care for patients admitted for rehabilitation is to facilitate achievement of each patient’s goals of care while maximizing medical, functional, psychological, and social functioning as a result of his/her participation in the program.

Our SCI/D inpatient service provides state-of-the-art services for Veterans and active-duty service members with SCI/D including acute comprehensive rehabilitation, comprehensive interdisciplinary annual evaluations for health maintenance and prevention of secondary complications, medical care for acute and chronic illness, surgical services, respite care, palliative care and comprehensive wound care management.

SCI/D related care may be provided on the inpatient unit at the Richmond VA Medical Center. Based on the needs of individual, we also collaborate with subspecialty services including cardiology, pulmonology, infectious disease, hematology/oncology, endocrinology, gastroenterology, dental, urology, plastic surgery, neurosurgery, general surgery, podiatry, and palliative care. Specialized diagnostic, surgical, medical, or emergent care is readily available and accessed onsite at the Richmond VA Medical Center.

Our interdisciplinary SCI/D Outpatient Team uses an integrated approach to provide comprehensive, coordinated, and patient-centered health care. We provide both specialized and primary care to Veterans with SCI/D. The emphasis is on wellness, prevention of complications, maximizing function and independence, and quality of life. Physical, social, and mental health care is provided by our team that includes SCI/D physicians, physician assistants, nurse practitioners, nurses, social workers, psychologists, physical therapists, occupational therapists, kinesiotherapy, recreational therapists, dieticians, pharmacists, and vocational rehabilitation specialists.

Examples of some of the specialized care that can be scheduled based on your individual needs and centered around the specialty clinic visit consist of:
- Mental health
- Sexuality
- Fertility Clinic
- Exoskeleton training
- Upper Extremity/Hand Clinic
- Advance Seating Clinic
- Urology and Urodynamics/Procedures Clinic
- Adapted Yoga
- Bowel and Bladder Care
- Wound Care Clinic
- Plastic Surgical evaluation
- Acupuncture Clinic
- Adaptive Sports
- Telehealth
- MS/ALS Interdisciplinary
- Smoking cessation program
- Chronic pain support group

Our SCI/D Home Care Program helps Veterans meet their medical management needs in their home while striving to optimize independence. The SCI/D Home Care team is under the direction of the SCI/D Outpatient Medical Director and consists of a full interdisciplinary team. The team directs their care toward promotion, maintenance, and restoration of quality of life and independence in the home and community.

Veterans who live within 100 miles of the Richmond SCI/D Center and are seen regularly at the Center may be eligible for services provided by the Home Care Program.

After an initial assessment by Home Care staff, Veterans work closely with the team to identify and formulate goals. Visit frequency varies, depending on the nature of the issues addressed. Home Care staff members are available to conduct educational sessions when needed by Veterans and their caregivers. When the goals are achieved or are no longer relevant, individuals may be discharged from the Home Care Program and continue their care through the SCI/D Outpatient Clinic.

Whole Health is an approach to care that supports your health and well-being. Whole Health centers around what matters to you, not what is the matter with you. This means your health care team will get to know you as a person, and work with you to develop a personalized health plan based on your values, needs, and goals.

At the Richmond SCI/D Center, we embrace Whole Heath through many pathways, and integrate it into your health care plan. Your Personal Health Plan is built around your immediate and long-term goals from acute rehabilitation to annual wellness checks and through life’s transitions.

Our interprofessional, team-based approach encompasses medical, physical, behavioral, and social drivers that influence individual and community health.

Learn more about how Whole Health can support your VA care.
- Find a local Whole Health point of contact to learn more about Whole Health where you get your care.
- Learn more about starting your Whole health journey
- Get inspiration from stories of other Veterans.

We take referrals from VA and non-VA facilities. Referrals can be done by fax or a phone call to the Admissions Coordinator. Patients and family may also contact the Admissions Coordinator to ask about eligibility. Our team will review and notify you of the decision and recommendations.

Preparing for a visit
We’ll contact you near their date of admission for preadmission screening and a review of the process. Special mode transportation may be arranged for patients who qualify. On-site accommodations (Fisher House) to support family and caregivers may be available. Lodging may also be available to Veterans and their support members for outpatient appointments. All patients, family, and visitors are required to comply with current Central Virginia VA HCS and SCI/D policies. Policies regarding visiting will be provided during the preadmission screening.

For questions or to leave a message for a patient, please contact the inpatient unit at (804) 675-5455

A list of the current medications you take, including vitamins and supplements

A copy of your Advance Directive

Necessary personal equipment, such as:
- Battery chargers, for power wheelchairs, cell phones, electric razors, etc.
- Transfer board, if you use one
- CPAP or BiPAP machine, if you use them
- Adaptive devices that aid in your daily routine, e.g., splints, braces, eating utensils
- Toiletries, e.g., toothbrush, toothpaste, shampoo, lotions, Chapstick, shaving razor
- A two-week supply of urinary catheters, colostomy supplies, etc. in the event the hospital generic supplies, that will be used and may not work as well, until special order items arrive.
- Personal earphones, earplugs

Bring comfortable, seasonal clothing, such as sweatpants, shirts, sweater, socks. A washer and dryer are available for your use. *Please be sure to label your laundry/tags with your name. Please do NOT bring:
- Smoking materials. Richmond VA is a Smoke Free facility.
- Valuables (i.e., money, credit cards, etc.), alcohol, or other drugs
- Weapons, knives, or firearms
- Medications and supplements - these will be provided during your admission.

As an SCI/D Center, we provide annual comprehensive preventative health evaluations. It is strongly recommended that Veterans with SCI/D get their annual evaluations from an SCI/D Center.

Services are provided on an inpatient or outpatient basis depending on your needs.

The annual evaluation addresses spinal cord injury and disorder issues including, mobility, self-management with daily living activities, bowel and bladder management and wellness health care areas such as cardiovascular, skin, respiratory, and sexual health, as well as other medical, therapy and psychosocial needs.

These comprehensive evaluations are completed by the interdisciplinary team.

SCI/D annual evaluations emphasize prevention of complications, early identification of problems, and continuance of optimal health. Both inpatient and outpatient annual evaluations are prescheduled in advance to ensure the check-up is efficient, effective and comprehensive. The SCI/D center works closely with the interdisciplinary team at the spoke facility to ensure continuity throughout the lifelong care of the Veterans with SCI/D.

Inclusion Criteria The Richmond SCI/D Center provides rehabilitation for eligible persons with SCI/D age 18 and over, when there is a reasonable expectation that rehabilitation will result in increased function, reduced secondary conditions, or improved quality of life for the person served and the family.

Persons eligible for admission to the Spinal Cord Injury/Disorder include:
- Active Military Duty Members
- Service-Connected Veterans
- Non-Service-Connected Veterans


Persons with the following conditions may be served: - Traumatic spinal cord injuries
- Vascular insults to the spinal cord
- Degenerative spine disease resulting in neurologic deficit
- Cauda equina syndrome producing neurologic deficits
- Inflammatory or infectious diseases of the spine or spinal cord resulting in neurologic deficits
- Demyelinating diseases of the spinal cord
- Intra-spinal neoplasms resulting in neurologic deficits

Exclusion Criteria
The following etiologies are not treated in the SCI/D System of Care: - Intracranial Etiologies. Quadriparesis or other paralytic conditions due to intracranial processes such as traumatic brain injury, brainstem, or cerebrovascular accident.
- Peripheral Neuromuscular Processes. Sensory and motor impairments due to peripheral nerve pathologies such as diabetic neuropathy or other peripheral neuropathies, Guillain-Barre, plexopathies, muscular dystrophies, myasthenia gravis or myopathies.
- No Spinal Cord Involvement. Etiologies and diseases that do not involve the spinal cord.

We support a broad spectrum of clinical research conducted by investigators both within and outside of the SCI/D Center, to address significant problems related to SCI/D, in line with our Mission to maximize functional independence, promote health throughout the lifespan and enhance quality of life.

The SCI/D clinical research team works closely with clinicians, patients, and other stakeholders to identify important topics for exploration that will improve quality of life and translate directly into patient care.

We currently are involved with multiple study protocols across many areas of study.

There are numerous opportunities for persons with spinal cord injury and disorders, both VA patients and others, to participate in clinical research. Call the SCI/D Research Team, (804) 675-5000, extension 3386, for more information about the SCI/D clinical research program and for opportunities to participate.

86% of our patients returned home following acute rehabilitation over past 3 years.
99% of patients reported overall satisfaction with service received over past 3 years.