Rancho Los Amigos National Rehabilitation Center is a rehabilitation hospital located in Downey, California, United States. Its name in Spanish means "Friends' Ranch". Rancho Los Amigos National Rehabilitation Center, or Rancho, dates back to 1888 when indigent patients from the Los Angeles County Hospital were relocated to what was then known as the Los Angeles County Poor Farm. Physical Therapy and Occupational Therapy were started in the late 1920s. The Rancho rapidly expanded after it was designated as a respiratory center for polio patients in 1951. In 1955, Dr. Vernon L. Nickel developed the halo vest, a device which is still in use to immobilize the cervical spine following severe neck injury or certain types of surgery. Drs. Jacquelin Perry and Robert Waters contributed to advances in pathokinesiology and treatment of spinal cord injuries, and other advances in rehabilitation of orthopedic and neurologic disorders were made in ensuing years. The Rancho Los Amigos Scale, a widely used scale to determine the cognitive level in brain-injured patients, was developed in the 1970s. Rancho Los Amigos National Rehabilitation Center is one of the largest comprehensive medical rehabilitation centers in the U.S. providing services to a wide range of individuals with catastrophic illnesses and injuries.