PERPOS stands for: Pate Environmentally Relevant Program Outcome System

The best way to describe Pate’s rehabilitation process is that it’s constantly evolving. Throughout an individual’s course of treatment, we’re working with the patient and family members, meeting with specialists, and modifying the program – sometimes day-by-day – to create and deliver the best solutions based on the individual’s specific needs.

Pate’s goal is to build a team and a personally-relevant treatment plan for each patient in order to help them achieve their highest level of independence. So, along with a unique approach to helping people with brain injuries, we’ve also developed our own unique method for monitoring success, which is Pate’s proprietary model for treatment.

It’s our own unique systematic assessment program called Pate Environmentally Relevant Program Outcome System – or PERPOS. It’s a numerical scale designed to help us directly measure an individual’s ability to re-enter society.

PERPOS is a measurement tool that focuses on the complex interactions of the environment and ability. It is comprised of:

  1. Amount of structure needed
  2. Distraction tolerated
  3. Overall functional ability

During the first week of treatment, we will evaluate:

  • Speech
  • Self-care
  • Physical/motor and cognitive abilities
  • Daily life skills

Lower PERPOS scores represent a greater degree of impairment, while higher scores represent a lesser degree of impairment.

These scores are determined during bi-weekly treatment team meetings, which include neuropsychologists, physical therapists, occupational therapists, speech language pathologists, case managers and other members of the clinical team. This approach accurately and precisely measures an individual’s distraction and structure tolerance and culminates in a plan that helps patients prepare for the next step in their lives.

High-level Structure, Low-level Distraction – Therapist directed activity provides patient with limited choices in a quiet environment with only the therapist and patient.
Mid-level Structure, Mid-level Distraction – Therapist aided activity in an environment with more people around and more to see.
Low-level Structure, High-level Distraction – Replication of real life situations such as grocery shopping that provides a highly distracted environment in which the patient may be structuring him/herself with little to no input from the therapist.


The treatment model at Pate Rehabilitation attempts to improve functional abilities in a way that maximizes transfer of gains made at the treatment facility to the patient’s home or work environments.

Maximum transfer of functional improvement to their environments occurs by treating patients’ functional impairments in various settings that closely resemble the environment in which they plan to use their skills.

The level of distraction and amount of structure present in each patient’s environment are the core elements of our treatment approach.  The PERPOS measures these elements, and this information informs therapists how well patients perform functional activities within different environments.

Our treatment teams monitor patients’ abilities, distraction tolerance, and need for structure on a biweekly basis and they frequently adjust treatment goals accordingly to better assist patients’ ability to return to their home and work environments.

How We Use PERPOS Information

  • Forecasting effective length of stay
  • Therapists’ treatment planning
  • Justification of progress to payor
  • Patient insight development
  • Progress monitoring (data bi-weekly)


Evaluation Process Overview

Phase 1: Preliminary Assessment

Every good relationship is built on understanding. So when a Clinical Liaison from Pate meets with a prospective patient for the first time, that’s our primary focus. We’ll talk with your family and any other professionals who may be working with you.

We’ll ask you about your goals and expectations. We’ll work to understand your needs — and to design a realistic financial plan. Because only by getting to know you can we make an informed recommendation for placement into the appropriate Pate program and team. We then assemble the best team of specialists for each patient, making family an integral part of the team.

Phase 2: Evaluation

Using our PERPOS scale, our Clinical Team assesses each patient to determine his or her individual needs. Areas evaluated during the first week of treatment are speech, occupational, cognitive ability, physical/motor skills, and a functional assessment.

Phase 3: Program Design

After the initial evaluation, the custom treatment plan is proposed. The first family conference is scheduled within the first 7-10 days of treatment. The plan is reviewed with all appropriate parties and input is considered.

Phase 4: Continuing Improvement

At every step of the treatment program, we use our PERPOS scale to monitor progress. We then use those PERPOS scores as a guide for modifying the process as needed — so that every patient gets the appropriate attention. Constant communication among members of the treatment team ensures accountability — while constant dialogue with the patient and family helps to keep everyone informed and in touch.

Phase 5: Discharge Planning

Discharge planning helps each patient prepare for the next phase of their life. During the treatment process, we’re constantly looking at what’s next — whether it’s a smooth transition into the workplace or a move home to live with family. Planning for the future helps us develop a personalized course throughout the recovery process.