The word "independence" is used a lot around Walton Rehabilitation Hospital as it tries to get those who have suffered a stroke or a serious car accident back to their lives. Now, it describes the hospital as well.

Walton, which bought out joint-venture partners University and St. Joseph hospitals earlier this year, is making major changes during the first several weeks of autonomy to comply with changing Medicare requirements that reduce the time patients can stay at the 58-bed hospital.

The hospital is making its patient rooms "rehab ready" to allow patients to get more in-room therapy using fixtures such as a wall-mounted bar that helps patients with standing and other exercises, Walton President and CEO Dennis B. Skelley said.

The special features will result in better outcomes for patients who "are so sick they can't go to those traditional gyms," he said.

The $2.5-million renovation, $1 million of which was raised through contributions, will create 28 private and 15 two-bed semi-private rooms.

Another Medicare regulation that requires the hospital maintain a percentage of patients with certain conditions caused overall admissions to drop, resulting in the layoff of 18 employees late last year. Some had been with the hospital for 15 years, Mr. Skelley said.

"From a management decision process, those probably were the most difficult decisions I had to make," he said.

That same rule, however, caused many facilities to abandon their inpatient rehab units, resulting in more patient referrals from hospitals in Columbia and in Athens, Savannah and Statesboro in Georgia.

"It is pretty much understood that complicated patients are referred to Walton," Mr. Skelley said.

The rehab system has also been asked to consider developing a residential unit for people with disabilities in Macon that is similar to its Harison Heights facility in Augusta, Mr. Skelley said.

What hasn't changed with the recent buyout is Walton's nonprofit status. The stake it acquired from its former partners, valued at $4.5 million each, means it now controls its own board appointments for the first time since it opened in 1988.

"It gives Walton a chance to step out on its own," said J. Larry Read, CEO of University Health Care System. "I think they're poised and they're ready to go."

Mr. Skelley said the hospital's new board will have 11 members. Board members Don Howard, Don Shaprio, Preston Sizemore, Dan Rahn, Robert Taylor, Tara Simkins and Phil Harison Jr. are working to fill the remaining four positions before the hospital's fiscal year begins in July.