LOVELAND, Colo. - Three weeks ago, Carol Roman of Denver climbed up a stack of hay bales to pull down a bale for her horse. Her hay hook didn't catch right, and she tumbled backwards, landing hard and shattering her tibia, a bone in her lower leg.

She had surgery at a hospital northeast of Denver and then transferred to the Northern Colorado Rehabilitation Center in Loveland, a new rehabilitation hospital similar to one planned for Casper.

Roman, 55, cried as she talked about how therapists helped her learn to walk again, how to do simple things like stand, climb a step, or put away dishes in a kitchen, leaning on her walker: "All the stuff I always took for granted."

"I can't believe what I've been able to do," she said. "I've come so far since I've been here."

Wyoming patients who have similar falls, or who have a stroke, brain injury, car accident or other trauma, could soon have another option for rehabilitation treatment.

Wyoming Medical Center and Ernest Health of Albuquerque are working out a deal to bring one of Ernest's 40-bed rehab hospitals to Casper, possibly in the McMurry Business Park.

The medical center today has only eight rehab beds.

"I have to turn a lot of people away," said Dr. Ryan Swan, a physiatrist who leads the rehab unit and a staff of physical, occupational, speech and recreational therapists. He could use at least 20 beds, he said, and with an aging population, that need will grow.

Often, patients go to Colorado for rehab, spending days or weeks away from their families.

In other cases, "A lot of times they have to get shuffled into local nursing homes," Swan said.

At nursing homes, a patient may receive one hour a day of therapy, compared to three or more at a rehab hospital.

"You lose that window," Swan said. "The best time to treat them is early."

Swan visited another of Ernest's hospitals, in Las Cruces, N.M. The company is building hospitals in smaller cities throughout the west.

"I came away very impressed," he said - not only with the well-trained staff and modern equipment, but also that the hospital hired a chef to serve up traditional Southwestern food to patients.

A look at the rehab hospital in Loveland is a preview of what Wyoming might expect.

Patients work with a doctor, nurse and case manager, all of whom coordinate in-patient care and eventual outpatient treatment and visit the patient's home to see if any accommodations need to be made. For example, one might need to widen a doorway for a wheelchair or install safety bars in a bathroom.

Patient rooms are spacious and private, but the patient might not spend much time there.

During the day a patient eats three meals in the cafeteria to help regain independence. They see several therapists depending on their needs. Physical therapists work on mobility, balance and stamina.

Occupational therapists help patients carry out daily living activities, like hygiene, dressing, eating and housekeeping, skills that are difficult after a stroke or surgery.

Speech-language pathologists help with reading, writing, speaking and swallowing. Respiratory therapists help patients regain lung function.

Patients meet with their therapists in their rooms, but also in offices, in the therapy gym or in the therapy pool.

In the gym, full of windows overlooking a mountain range, a physical therapist helped a man who'd fallen and hurt his wrist and face. She led him through stretching and strength exercises, to make him less likely to fall again.

"It really makes you work your hip, and work your stomach, and hold, 1, 2, 3, breathe," she told him.

The gym has treadmills, a staircase, parallel bars and exercise tables. Outside picture windows is a garden where patients learn to walk on different surfaces: grass, concrete, a wooden deck and gravel.

Patients can be as young as 14. The typical stay is about two weeks but can be shorter or longer depending on the illness.

The hospital's primary market is the burgeoning region including Loveland, Greeley and Fort Collins. But they also draw from Denver, Laramie and Cheyenne.

It's a busy area: The Northern Colorado Rehabilitation Center was built in a cornfield on the intersection of I-25 and Highway 35 in Loveland, Colo.

The other corners of the intersection are home to a 3,000-acre development called Centerra, featuring an outdoor mall, several restaurants, business offices and upscale homes.

Across the interstate, cranes are putting together the new Medical Center of the Rockies, a 136-bed hospital offering trauma services, heart care, delivery, pediatrics and other services.

Casper may not be as bustling, but a rehab hospital would be welcomed, said Dr. Swan in Casper. Then people could go to Colorado to shop, but stay home for health care.

"This will be a one-of-a-kind facility in Wyoming," he said. "We really have nothing to compare. It'll be nice for the people to get all their rehab services in the state."

Reach Barbara Nordby at (307) 266-0633 or at barbara.nordby@casperstartribune.net.