What Is An Acute Rehab Facility? (Best solution)

Acute rehabilitation is a program, usually based in a hospital, that helps people who have experienced some major injury, disorder or illness to regain the skills needed to return to everyday living.

What is acute rehabilitation?

  • Acute Rehabilitation. Burke is an acute rehabilitation hospital. Patients are admitted who have a traumatic injury, debilitating disease or following certain types of surgery. Acute rehabilitation is appropriate for patients who will benefit from an intensive, multidisciplinary rehabilitation program.

Contents

What is the difference between acute care and rehab?

Acute care patients usually come straight from the hospital, opening up beds for patients who need medical help, and they come to rehab when they are stable, but still need a tremendous amount of assistance that they wouldn’t be able to receive in a home setting.

What’s the difference between acute care and inpatient rehab?

An acute condition is one that doesn’t require extended hospitalization. Therefore, acute care therapy, which is specifically designed to treat acute conditions, is typically shorter than inpatient rehabilitation. Acute care therapy is often provided for those who need short-term assistance recovering from surgery.

What is an acute inpatient rehab facility?

Acute inpatient rehabilitation (also called “acute rehab”) is a program that helps you recover after a stroke, brain injury, spinal cord injury, or other event that has affected your ability to live as you have been living.

What is the difference between a rehab center and a nursing home?

While nursing homes are looking for patients who need long-term or end-of-life care, rehabilitation centers are focused on helping residents transition back to their everyday lives.

What does an acute rehab nurse do?

Rehabilitation nurses provide care that helps to restore and maintain function, and prevent complications. They also provide patient and family education, counseling, and case management.

Is acute rehab considered acute care?

Patients often ask, What is acute rehabilitation? The easiest way to describe acute rehab is to describe its role in comparison to post acute care. Patients are often admitted to acute care when they require medical treatment in combination with close monitoring for an acute illness.

Is acute long term?

Most people who need inpatient hospital services are admitted to an “acute‑care” hospital for a relatively short stay. But some people may need a longer hospital stay. Long‑term care hospitals (LTCHs) are certified as acute‑care hospitals, but LTCHs focus on patients who, on average, stay more than 25 days.

What are examples of acute care?

Acute care settings include emergency department, intensive care, coronary care, cardiology, neonatal intensive care, and many general areas where the patient could become acutely unwell and require stabilization and transfer to another higher dependency unit for further treatment.

What is the 60% rule in rehab?

The 60% Rule is a Medicare facility criterion that requires each IRF to discharge at least 60 percent of its patients with one of 13 qualifying conditions.

What is the difference between acute and post acute care?

Post-acute care includes rehabilitation or palliative services that beneficiaries receive after or in some cases instead of, a stay in an acute care hospital. Depending on the intensity of care the patient requires, treatment may include a stay in a facility, ongoing outpatient therapy, or care provided at home.

What are the 3 levels of rehabilitation?

The three main types of rehabilitation therapy are occupational, physical and speech. Each form of rehabilitation serves a unique purpose in helping a person reach full recovery, but all share the ultimate goal of helping the patient return to a healthy and active lifestyle.

What is the difference between rehab and therapy?

Rehabilitation is the process that assists a person in recovering from a serious injury, while physical therapy will help with strength, mobility and fitness.

What’s the Difference Between Acute Rehab and Subacute Rehab? – Hudsonview

“”Rehabilitation,” often known as rehab, is much more than a simple catch-all term for a recovery program; there are many distinct forms of rehabilitation aimed at patients at various stages of their rehabilitation.” So, what exactly is the difference between acute rehabilitation and subacute rehabilitation?

What’s acute rehab?

Acute rehabilitation is a form of intensive rehabilitation for individuals who have suffered a significant medical trauma and require considerable efforts to help in their recovery. Some patients may have suffered a stroke, may have recently undergone major surgery, may have had an amputation, or they may be coping with a terrible disease at the time of their visit. Unless they get intensive therapy and medical support, the vast majority of these individuals will either not be able to recover completely or will not be able to heal in a fair length of time.

They then proceed to rehabilitation when they have stabilized but still require a significant amount of assistance that they would not be able to receive in their home environment.

Patient’s get 3-5 hours of treatment each day, which may include a combination of speech, physical and occupational therapy as well as any additional acute therapies, such as respiratory therapy or electromagnetic therapy.

Acute patients are expected to make rapid improvement and proceed up a level once they have completed acute rehabilitation.

What is subacute rehab?

Subacute rehabilitation is a level of care that is lower than acute rehabilitation in terms of severity, the patient’s state, and the rehabilitation efforts. Patients may be discharged from the hospital directly into a subacute rehabilitation facility if their rehabilitation needs are not urgent, or they may be transferred from acute rehabilitation to subacute rehabilitation at a facility if their situation changes. Additionally, a patient may be transferred from a specific acute care facility to a subacute care facility, such as Hudson View, if their condition has worsened and their requirements have altered.

Subacute rehabilitation involves just around 2 hours of therapy every day, as well as frequent visits from a physician.

Example: A diabetic patient recuperating from amputation may be doing well in subacute rehab until a nurse notices an open wound that has to be attended to right away.

Home care is generally the next stage for patients who have completed subacute rehabilitation. Patients might get either home treatment and nurse visits or outpatient rehab until their rehabilitation is complete.

Acute Inpatient Rehab Hospital vs. Skilled Nursing Facility (SNF)

Your doctor may recommend going into rehab after discharge from the hospital. That means that before going home, you’ll stay for a period of time at a facility where you will participate in a physical rehabilitation program that can help you regain strength, mobility, and other physical and cognitive functions. Before you decide on where to rehab, check the facts.

Skilled nursing facility

acute care
Length of stay
The national average length of time spent at a skilled nursing facility rehab is 28 days. The national average length of time spent at an acute inpatient rehab hospital is 16 days.
Amount (and intensity) of therapy
In a skilled nursing facility you’ll receive one or more therapies for an average of one to two hours per day. This includes physical, occupational, and speech therapy. The therapies are not considered intensive. In an acute inpatient rehab hospital you’ll receive a minimum of three hours per day, five days a week, of intensive physical, occupational, and speech therapy. Your therapy is provided by rehab specialists who incorporate advanced technologies and approaches into your regimen.
Physician involvement
An attending physician provides a comprehensive initial assessment within 30 days of your admission into a skilled nursing facility. An attending physician, physician assistant, or nurse practitioner is only required to visit you once every 30 days. Physician care is provided 24 hours a day, seven days a week. A rehabilitation physician will visit you at least three times per week to assess your goals and progress.
Nursing care
A registered nurse is required to be in the building and on duty for eight hours a day. More often, patients are seen by certified nurse aides. A registered nurse is available in the evening and off hours. The nurse-to-patient ratio is one nurse aide to 20 to 30 patients. Nursing care is provided 24 hours a day, seven days a week, by registered nurses as well as Certified Rehabilitation Registered Nurses (CRRN). The nurse-to-patient ratio is one nurse to six or seven patients.
Treatment team
In addition to a monthly visit from an attending physician, you may receive additional visits from a physician assistant, nurse practitioner, or clinical nurse specialist. Sub-acute teams include physical, occupational, and speech therapists, and a case manager. Your highly trained, multidisciplinary personal rehab team, consisting of rehabilitation physicians, internal medicine physicians, nurses, therapists, care managers, dietitians, psychologists and family members, work together to help determine goals and the best individualized treatment approaches for you.

Which rehab is right for you?

Come see if Bryn Mawr Rehab is right for you. Visit our beautiful grounds and learn about our state-of-the-art technologyand therapeutic amenities that distinguish us from every other rehab hospital in the Philadelphia region.

Skilled nursing facility Bryn Mawr Rehab Hospital

What is Acute Rehabilitation?

Acute Rehabilitation is a type of rehabilitation that occurs quickly. Burke Medical Center is a short-term rehabilitation facility. Patients who have suffered a catastrophic injury, a debilitating condition, or who have had specific types of surgery are hospitalized. Patient’s who will benefit from an intense, interdisciplinary rehabilitation program are ideal candidates for acute rehabilitation services. Patients get physical, occupational, and speech therapy as needed, and their medical care is provided by clinicians who have received further training.

  • When it comes to patients with neurological illnesses, there is a neuropsychologist on staff who can decide if they require extra psychological or psychiatric intervention.
  • Patients get up to three hours of therapy every day, often from Monday through Friday, and one hour on Saturday and Sunday, depending on their circumstances.
  • A variety of additional therapies, such as respiratory therapy and therapeutic recreation activities, are provided to patients while they are undergoing rehabilitation.
  • Treatment at the sub acute stage is less intense than treatment at the acute level.
  • Patients at a sub acute institution often get between one and two hours of therapy each day, depending on their condition.
  • Patients who are not ideal candidates for acute rehabilitation can be sent to Burke’s network of associated sub acute institutions, which are staffed by physical, occupational, and speech therapists who have received Burke training.
  • The New Jewish Home/Sarah Neuman Westchester and United Hebrew are two of the most popular options.

What Is Acute Rehabilitation?

Patients frequently inquire, “What exactly is acute rehabilitation?” The most straightforward method to characterize acute rehabilitation is to contrast its role with that of post-acute care. Patients are frequently brought to acute care when they require medical therapy in conjunction with intensive monitoring for a severe disease that requires immediate attention. Many different illnesses might affect patients in acute care facilities. Heart attack, stroke, pneumonia, and an exacerbation of COPD are just a few of the most prevalent health problems.

  1. Patients in acute care may benefit from treatments such as close monitoring of vital signs, administration of IV drugs, dressing changes, and support with activities of daily life.
  2. Additional services such as physical and occupational therapy, in addition to closely monitored ambulation, may be necessary for many weeks following their acute hospitalization, sometimes as frequently as five times per week.
  3. This is when post-acute rehabilitation institutions, such as Santé, come in handy.
  4. Physical, restorative, and occupational rehabilitation services are provided on-site as required by the provider to ensure the greatest amount of convenience for the guests.
  5. Additional services include the management of medication and treatment plans in accordance with the directions of the practitioner.

We are delighted to answer any questions you may have, such as, “What is acute rehabilitation?” or “What can I expect?” We will walk you through the whole process. For additional information, please contact us at Santé now. Return to the Library

Acute Care Therapy vs. Inpatient Therapy: What is the Difference?

It’s understandable if you’re new to the sector that the rehab treatment area might be a bit perplexing. To get your mind around the various settings, care techniques, and industry jargon, you’ll need to do some research. Even the most experienced rehabilitation therapists have difficulty keeping track of everything. When it comes to the numerous types of rehab treatment spaces, two of the most frequently confused are acute care therapy and inpatient therapy, which is also known as inpatient rehabilitation or inpatient rehab.

What acute care therapy and inpatient rehab have in common

Both forms of rehabilitation treatment aid in the recovery of those who have suffered an injury or sickness. Physical, occupational, and speech therapy are used to aid patients in recovering their independence after being hospitalized. During the course of treatment, mental health treatments may also be incorporated as needed. In addition, both acute care treatment and inpatient therapy can be offered on an individual basis or as part of a group setting, depending on the circumstances.

How acute care therapy and inpatient rehab differ

For starters, it is critical to recognize that “inpatient” refers to merely remaining in a hospital, care facility, or, in certain cases, a skilled nursing home for a specified period of time (SNF). As a result, technically speaking, acute care treatment and inpatient rehabilitation are both regarded “inpatient” care in the traditional sense. The nuances are where the distinct differences may be found. Acute care therapy and inpatient rehabilitation have a distinct recovery timetable than each other because of the differences in treatment needs, which might change based on the severity of the injury, sickness, or amount of recovery time necessary.

It is possible that different degrees of professional approach will be required to provide different outcomes as a result of differing levels of damage severity.

Let’s take a deeper look at the distinctions between acute care treatment and inpatient rehabilitation therapy.

What is acute care therapy?

Any illness or disease that does not require prolonged hospitalization is considered acute. The duration of inpatient rehabilitation is often longer than the duration of acute care therapy, because acute care therapy is especially designed to address acute illnesses. Acute care treatment is frequently offered for patients who require short-term help while recuperating from surgery or other medical procedures. The purpose of acute care treatment remains the same: to equip patients with the skills they need to function independently once they have been discharged from the hospital.

Because acute care therapy is concerned with rehabilitating vital abilities and motor functions, treatment is provided on a daily or multiple times daily basis in most cases.

It’s vital to highlight that acute care therapy is not considered a stand-alone treatment but rather a component of comprehensive care.

For example, a patient may have undergone shoulder surgery, and acute care treatment may be only one component of their overall care. Patients in inpatient rehab, on the other hand, are there only for the purpose of receiving rehab therapy.

What is inpatient therapy/inpatient rehab?

An IRF is one method via which physicians can deliver inpatient rehabilitation (inpatient rehabilitation facility). IRFs, which are separate from the hospitals from which patients would have been released, provide intensive rehabilitation and therapy for people who have suffered from a life-threatening disease or devastating disability. Inpatient rehabilitation facilities (IRFs) are typically a suitable match for people who have had a stroke, knee replacement, or brain injury since the purpose is to provide a full range of medical and personal services while concentrating closely on a properly prescribed rehab routine.

  1. Inpatient therapy might range anything from a few weeks to many months.
  2. The length of inpatient rehabilitation stays is determined by the severity of the patient’s illness and the rate at which the patient is projected to develop in his or her rehabilitation.
  3. Ultimately, the purpose of inpatient therapy is to assist patients in gaining their independence by teaching them how to manage their disease at home or in a community setting.
  4. In order to achieve these objectives, therapists spend a large amount of time with patients in inpatient therapy.

Different tools and systems

In order to accommodate the distinct nature of the acute therapy environment and the distinct operational demands that it imposes in comparison to inpatient therapy, hospitals and care networks frequently implement specialized software platforms, such as Net Health Therapy, within acute therapy departments. These electronic health record (EHR) systems aid in the streamlining of processes such as patient paperwork, treatment planning, staff scheduling, patient visits, and bill-paying procedures.

What does each form of care look like for patients?

In order to accommodate the distinct nature of the acute therapy environment and the distinct operational demands that it imposes in comparison to inpatient therapy, hospitals and care networks frequently implement specialized software platforms, such as Net Health Therapy, in acute therapy departments. Electronic health record (EHR) systems serve to speed processes such as patient recording, treatment planning, staff scheduling, patient visits, and invoicing for healthcare providers.

Many hospitals employ institution-wide EHR systems for inpatient therapy, which are more broad and are used across a variety of departments rather than department-specific systems.

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Rehabilitation comes at a critical juncture in the healing process, making it critical to select the most suitable degree of treatment. Despite the fact that many healthcare providers refer to their services as rehabilitation, the degree and intensity of care provided might differ significantly from one provider to the next. The following graphic explains the difference between acute and subacute rehabilitation services. These materials will assist you in determining the best course of action for you or a loved one.

Inpatient Rehabilitation Hospital* Skilled Nursing Facility Long Term Care Hospital Home Health Outpatient Rehabilitation**
Length of Treatment Average 10-18 days Average 25 days 25 days or longer Variable, based on treatment plan Variable, based on needs
Therapy Intensity Intensive, skilled care; often integrating advanced technologies Less intensive than inpatient rehabilitation, but not regulated As needed, usually low intensity Variable, based on treatment plan Variable, based on needs
Amount of Therapy Typically 3+ hours per day Typically 1-1.5 hours per day (up to 3 hours) Variable 30-60 minutes per sessiondiscipline, usually 3 times per week 30-60 minutes per sessiondiscipline, 2-3 times per week
Physician Involvement Daily face-to-face assessment and treatment plan update At least every 30 days Available, not on-site daily Provide oversight but no direct treatment As needed to evaluate progress and assess treatment plan
Skilled Nursing Care – RN Care from RN 24 hours per day RN on site for at least 8 hours/day, care typically provided by techs 24 hours/day As needed per treatment plan N/A

* This service is provided by the Sheltering Arms Institute in conjunction with VCU Health. * This service is available at Sheltering Arms Outpatient Rehabilitation Centers. Our concussions rehabilitation program is the only one that provides physician services. There are normally two alternatives for those seeking rehabilitation services: an Inpatient Rehab Facility or a Skilled Nursing Facility, depending on their needs. In the following chart, we detail the distinctions between different treatment alternatives to assist you in determining which option best matches your current medical and rehabilitation needs.

Service Inpatient Rehabilitation Facility (Hospital) Skilled Nursing Facility
Physician Visits Daily 1-3 times per week
Type of Physician Physiatrist, a doctor who specializes in physical medicine and rehabilitation (24-hour availability Geriatrician, internist, or family practitioner (Limited availability)
Consultants All specialties readily available Limited specialist availability
Nursing Hours of Care 5.5 and higher hours per day, primarily registered nurses (24-hour availability) 2-3 hours daily, primarily certified nursing assistants
Nursing Skill Mix Professional registered nurses specializing and certified in rehabilitation nursing Nursing assistants certified in long-term care with LPN/RN supervision
Function Complex level of care, patient and family education Basic level of care support
Integration of Care Coordinated multidisciplinary team directed by physician Several individual disciplines
Average Length of Stay 10-35 days, depending on diagnosis 24-60 days
Therapy Intensity 3 hours per day, 5 days per week 45-90 minutes, 3 times per week
Team Meetings Multidisciplinary team meetings lead by physician including family Several individual disciplines
Neuropsychologists Full-time Limited
Physical and Occupational Therapy Registered physical and occupational therapists Physical therapy assistants and certified occupational therapy aids deliver much of the care
Audiologist, Therapeutic Recreation, Social Worker Full-time Limited
Speech Language Therapist Full-time Limited
Accreditation Joint Commission None
Quality Improvement Quality Assurance/Utilization Review None
Driver Training Full-time None
Prosthetist/Orthotist Full-time Limited
Prosthetist/Orthotist Evaluated by licensed clinician and accepted by medical doctor Accepted by admissions

* Sheltering Arms Institute, in cooperation with VCU Health, is offering this service. * This service is available at Sheltering Arms Outpatient Rehabilitation Clinics only. Only our concussions therapy program provides access to physician services. There are normally two alternatives for those seeking rehabilitation services: an Inpatient Rehabilitation Facility or a Skilled Nursing Facility. In the following chart, we detail the distinctions between different treatment alternatives to assist you in determining which option best matches your current medical and rehabilitation requirements.

Questions and Answers About Sub Acute Rehabilitation for Inpatient Care

Sometimes, despite your best attempts at rehabilitating in a SAR facility, you may not be able to regain enough strength or function to be safe at home immediately after your injury. It’s understandable that not being able to achieve your aim of returning home would be depressing. The SAR social worker will assist you in exploring other choices, which may include relocating to a skilled nursing facility, such as assisted living, or entering an adult foster care facility. They may also be able to collaborate with your family members and community organizations to give additional help at home to make this choice more safe.

Depending on your situation, you may be able to get a lower level of treatment services via Medicare Part B in a skilled nursing facility, which may allow you to return home in the future if your function steadily improves.

Differences Between LTACHs, IRFs and SNFs

When patients are discharged from the hospital following a catastrophic illness or accident, but they still require care, a variety of institutions can assist them in making the transition back to their homes. Patients in critical condition are cared for at long-term acute care centers (LTACHs). Ten to twenty percent of patients recovering from catastrophic diseases will develop permanent organ failures, necessitating the need for extensive and expensive medical treatment. Stays in LTACHs are becoming more common in these and other circumstances.

According to the United States Department of Health and Human Services, 35 percent of all Americans will require care in a nursing facility at some point in their lives, with long-term acute care facility (LTAC) and inpatient rehabilitation facility (IRF) stays adding to that figure even more significantly.

We will explain what long-term acute care hospitals (LTACHs), intermediate rehabilitation facilities (IRFs), and skilled nursing facilities (SNFs) are, examine the distinctions between them, and provide guidance on how to find a care facility that is best for you or your family.

What Is a Long-Term Acute Care Hospital?

Patient-centered medical homes are high-quality facilities for people who are still sick enough to require a high degree of sophisticated care. Despite the fact that these patients do not require hospitalization in the critical care unit or for emergency treatment since their health is largely stable, they nonetheless require a more sophisticated level of care than is available at many other hospitals. An LTACH provides treatment that is similar to that provided in a hospital setting, but in a more long-term setting.

Hospitalization in LTACHs is more likely to be required for patients requiring intravenous drugs or fluids or who are receiving their nourishment through a feeding tube.

Generally, admission to an LTACH is contingent on medical paperwork demonstrating that the patient has a complex recovery ahead of him or her that will need long-term inpatient care.

What Is an Inpatient Rehabilitation Facility?

An IRF is a facility that provides intense, creative therapeutic and rehabilitative treatment to patients who have suffered a catastrophic accident or illness and are attempting to restore function. Patients live at the inpatient facility and get extensive daily therapy to help them strengthen and restore their bodies, which they do while they are there. Patients are expected to participate in rehabilitation programs that last at least three hours per day, five days a week, at these institutions, according to the caretakers.

These include brain traumas, stroke, and other neurological illnesses, as well as multiple joint replacements and pelvic or lower extremity fractures.

These objectives guide the planning of therapies and treatments by health-care professionals.

Individualized rehabilitation facilities (IRFs) are useful because they provide patients with individualized solutions for regaining their abilities following serious accidents or illnesses.

Some patients, on the other hand, will require a more extensive degree of care than can be provided by an IRF.

What Is a Skilled Nursing Facility?

After being discharged from the hospital, many patients choose to stay in a skilled nursing facility as an alternative to continuing their medical care. It is typically appropriate for patients who do not require the high degree of care provided by a long-term acute care facility but who still require medical attention and assistance before they are able to live independently on their own. In addition to custodial care, which includes assistance with managing everyday requirements such as getting dressed, bathing, and going to the restroom, skilled nursing care can also include medication administration and monitoring.

A skilled nursing facility is frequently used to offer ongoing care for patients who have suffered from ailments such as heart attacks or shock, hip or femur fractures or operations, joint replacements, sepsis, renal and urine infections, and other serious illnesses or injuries.

The average patient admitted to a skilled care facility must commit to one to one and a half hours of therapy every day in order to be considered.

Many patients find skilled nursing facilities to be beneficial because they provide high-quality care and can help them manage their medical conditions.

The Main Differences Between LTACHs, IRFs and SNFs

The following components of care and treatment differ significantly across LTACHs, IRFs, and SNFs:

  • Intricacy of medical treatment: The medical care offered at LTACHs is significantly more complicated than the medical care provided at SNFs and IRFs. Inpatient rehabilitation centers or skilled nursing facilities, depending on the patient’s conditions, are likely to be preferred over long-term acute care hospitals for patients who require more moderate care. Inpatient rehabilitation clinics are often the best option for patients who require specialized therapies and rigorous rehabilitation programs in order to regain their freedom after a hospitalization or surgery. Long-term acute care hospitals may provide certain treatments and rehabilitation services, but these are not the primary emphasis of the facility. Skilled nursing institutions can provide the same functions, but on a less intensive scale. Patients who do not willing to commit to three hours of therapy or rehabilitation each day may wish to look for alternatives to inpatient rehabilitation institutions
  • For example, outpatient rehabilitation facilities. The facility’s staff: Long-term acute care facilities often have a stable of in-house doctors, and patients will normally visit a doctor at least once per day. Medical staff members are also present at inpatient rehabilitation centers and skilled nursing facilities, although therapists and nurses are responsible for the majority of the daily care management. Long-term acute care hospitals are the most expensive of the three alternatives due to the fact that they provide more sophisticated and intense medical treatments than the other two. Although private insurance programs, Medicare, and in some cases Medicaid can help with the costs, skilled nursing facilities are more cost-effective solutions for individuals who do not have complicated care demands.

Contact Post Acute Medical for Your Medical Care and Rehabilitation Needs

Post Acute Medical is here to assist you when it comes to selecting a care facility for yourself or a family member. We can assist you in locating the most appropriate level of medical care or rehabilitation services for your needs. More specialist services are available to us than at other acute care institutions, and we also have modern medical facilities, as well as a large amount of therapeutic equipment. Yet our compassionate and cheerful staff makes all the difference – regardless of your medical needs, you can rely on our team to treat you as an individual, take your personal requirements into consideration, and provide you with the finest care possible during your recuperation period.

Difference: Acute Care vs Subacute Care Rehabilitation

A catastrophic injury, surgery, or chronic ailment might result in a prolonged stay in the hospital, which can make it difficult to navigate the complex medical care system. When all that is on your mind is getting well, it can be difficult to determine the best sort of treatment you will require, and deciding where to receive that care can be a challenging issue for patients and their families when all you are thinking about is getting better. How can you evaluate the degree of care you require, as well as which institution in your area will be the most effective in meeting those requirements?

The healing process may be divided into several categories of care and rehabilitation.

These include acute care, subacute care, and even long-term care facilities. We will discuss the distinctions between acute care rehabilitation and subacute care rehabilitation, as well as the implications of these changes for you.

Understanding The Differences Between Acute Care and Subacute Care Rehabilitation

The degree of care you or your loved one will require will be determined by the severity of the injury and the rehabilitation plan you have in mind. There are a few illnesses or injuries that might benefit from acute treatment and subacute care, and they are listed below.

What is Acute Care Rehabilitation?

Patients who have suffered from a severe accident or disease, or who have recently undergone acute care surgery, can benefit from acute care rehabilitation, which is rigorous therapy. A patient who suffers from any of the following conditions is eligible for acute care rehabilitation:

  • Heart attack
  • Minor stroke
  • Pneumonia
  • Chronic obstructive pulmonary disease (COPD) or other severe respiratory diseases
  • Some forms of surgery

Acute Care is reserved for people who are physically and mentally capable of enduring the rigors of daily, rigorous therapy.

  • Sessions for acute therapy last three or more hours each day on average. On average, patients receive treatment at least 5 days a week
  • Patients receive regular face-to-face examinations and updates on their treatment plans. According to their needs, patients will get a variety of therapies including physical, occupational, and speech therapists. A comprehensive healthcare strategy is employed to guarantee that each patient’s ability to operate in their everyday lives is restored.

Patient’s quality of life and comfort can be improved by acute care, which can help them transition to daily life without therapy or, if necessary, to subacute care. Acute care can help patients achieve a continually evolving goal that improves their quality of life and comfort until they are able to transition to daily life without therapy or, if necessary, to subacute care.

Subacute Care

It is nevertheless considered intense and indicates a high degree of care for which particular training and, in certain cases, formal licensing are required. Patient’s who are very ill or injured and are unable to handle the extensive, daily therapy sessions found in acute care are referred to as subacute rehabilitation.Subacute care is for any patients who require therapies that include:

  • Spinal cord injury (SCI), traumatic brain injury (TBI), neuromuscular problems, congenital conditions, intensive wound care, intravenous therapies, and other conditions Issues with GI Tubes
  • Stroke-related problems that endure a long time
  • Malnutrition or eating disorders
  • Critical illnesses
  • And other serious problems
  • Cancer, ALS (Lou Gherig’s Disease), or any other terminal illness that is still in its early stages

When someone has previously finished with acute treatment but still requires additional therapy to restore full functionality in their everyday lives, subacute care is supposed to be an ideal solution for that person. It is a less intense kind of therapy that comprises the following elements:

  • Therapy sessions that can take no more than two hours each day on average
  • It is important to hold frequent meetings with patients, their families, and other members of the care team to ensure that everyone is working toward the same goals and is communicating effectively. Throughout therapy, the emphasis is on recovering strength, mobility, and long-term functionality
  • Physical, occupational, and speech therapy are utilized in conjunction with one another to get the best outcomes. Adding other forms of therapy, such as respiratory therapy, can help to provide a more comprehensive approach to subacute care

While subacute treatment is comprehensive in its approach, the ultimate goal is for patients to be able to return to their regular, daily lives with the greatest amount of strength, comfort, and functionality as they possibly can. A patient’s ability to return to their usual life after suffering from a catastrophic illness or accident can be challenging, especially if their new normal is different from their previous one. Subacute care can help in this situation since it allows patients to take their time transitioning to a new quality of life, both emotionally and physically, after a hospitalization.

Choosing The Best Path

Following a knowledge of the differences between acute and subacute care rehabilitation, the following step is to select the most appropriate institution that offers the most appropriate therapy type. You always want to make the greatest option for your loved one, and this is no exception. Sierra Care delivers subacute care and therapies that are unmatched in the industry for patients recuperating from medically complicated diseases, traumatic brain injuries, and spinal cord injuries, among other conditions.

Sierra Care’s treatment staff can also assist you in navigating the complex world of health insurance benefits and processes, including MediCal, to ensure that you are obtaining the most amount of coverage available for your therapy.

Please refer to the following link for a comprehensive list of programs and services provided by the medical rehabilitation centers at Sierra Care: click here.

They understand the stress and anguish that comes with caring for a sick or injured loved one, and they are here to assist you in making the many crucial decisions that are involved in choosing subacute care for your loved one.

You can recommend a loved one or patient to Sierra Care by visiting the link above and completing the appropriate information. In order to provide a complete, industry-leading approach for all patients, Sierra Care brings together the best components of a subacute level of care.

Inpatient Rehabilitation Facilities and Skilled Nursing facilities: Vive La Difference!

In a study comparing the outcomes of patients who were treated in inpatient rehabilitation facilities (IRFs) with those of clinically and demographically similar patients who received their post-acute rehabilitation in skilled nursing facilities (SNFs), it was discovered that IRFs provide better care to their patients across a number of outcome measures – IRF patients live longer, spend more days at home and fewer days in health care institutions, have fewer emergency room visits, and, for patients with severe mental illness, have fewer hospitalization The findings of this study have important implications for site-neutral payment proposals and bundling demonstrations, both of which are expected to result in a movement of patients to skilled nursing facilities.

The Study’s Findings It was commissioned by the American Medical Rehabilitation Providers Association’s ARA Research Institute to investigate the impact of the revised classification criterion for inpatient rehabilitation facilities, which was implemented in 2004 and required that 60% of patients in IRFs be treated for one of 13 conditions.

From a starting point of a 20 percent sample of patients treated in skilled nursing facilities and a 100 percent sample of patients treated in Intensive Care Facilities (IRFs) between 2005 and 2009, the study looked at a subgroup of patients with illnesses that were the same in both settings.

  • In this cross-sectional study, researchers looked at the distribution of clinical problems among patients treated in two different settings following implementation of the 60 percent rule. Patients admitted to IRFs for lower extremity joint replacement (hip/knee replacement), stroke, and hip fracture accounted for 60.4 percent of all IRF admissions in 2005
  • By 2009, the percentage had dropped to 52.4 percent due to a fall in the number of patients admitted. (In subsequent years, the proportion decreased to 45.9 percent of admissions in 2010 and 40.8 percent of admissions in 2013.) Patient volume at IRFs for stroke, significant medical complexity, neurological diseases, and brain damage all rose between 2005 and 2009
  • The percentage of patients treated at IRFs for each condition increased throughout this time period.

The greatest improvement was seen in patients who had hip or knee replacements. These individuals were admitted to the IRF at a rate that decreased from 25.4 percent of all IRF admissions in 2005 to 14.5 percent of all IRF admissions in 2009.

  • The longitudinal investigation looked back over a two-year period at patients’ clinical results as well as the overall amount of Medicare payments made on their behalf by the hospital (excluding payments for physician services and durable medical equipment). On five out of six metrics, the researchers discovered that IRF patients had superior clinical outcomes than those treated in skilled nursing facilities. According to the sixth measure, hospital readmissions, in-patient rehabilitation (IRF) patients had fewer hospital readmissions than in-patient skilled nursing facility (SNF) patients for five of the thirteen conditions studied (amputation, brain injury, hip fracture, major medical complexity and pain syndrome).

Dobson DaVanzo provided data for all situations as well as for each of the 13 conditions that were evaluated individually. The data shown here is for all conditions, with some samples of condition-specific data included for comparison. Clinical Outcomes are what you get at the end of the day.

Issue IRF Patients SNF Residents
Average length of stay in post-acute care for all clinical categories 12.4 days 26.4 days
Risk of mortality in two years for all clinical categories 24.3% 32.3%
E.g., Risk of mortality in two years, hip fracture 25.4% 33.7%
E.g., Risk of mortality in two years, hip/knee replacement 5.2% 5.9%
E.g., Risk of mortality in two years, stroke patients 34.2% 48.4%
Additional days of life for all clinical categories 621.0 days (20.7 months) 569.1 days (18.9 months)
E.g., additional days of life, hip fracture 622.4 days 567.3 days
E.g., Additional days of life, hip/knee replacement 712.2 days 708.3 days
E.g., Additional days of life, stroke 572.2 days 475.5 days
Ability to remain home without facility-based care for all clinical categories 582.3 days 530.8 days
E.g., Ability to remain home without facility based care, hip fracture 581.2 days 528.4 days
E.g., Ability to remain home without facility-based care, hip/knee replacement 698.0 days 693.4 days
E.g., Ability to remain home without facility-based care, stroke 518.4 days 426.4 days
Emergency room visits for all clinical categories 642.7 ER visits/1000 patients/year 688.2 ER visits/1000 patients/year
E.g., Emergency room visits, hip fracture 576.5 ER visits/1000 patients/year 613.3 ER visits/100 patients/year
E.g., Emergency room visits, hip/knee replacement 413.1 ER visits/1000 patients/year 432.3 ER visits/1000 patients/year
E.g., Emergency room visits, stroke 785.9 ER visits/1000 patients/year 823.0 ER visits/1000 patients/year
Hospital readmissions for all conditions 957.7 readmissions/1000 patients/year 1,008.1 readmissions/1000 patients/year
E.g., Hospital readmissions, hip fracture 838.1 readmissions/1000 patients/year 891.1 readmissions/1000 patients/year
E.g., Hospital readmissions, hip/knee replacements 499.9 readmissions/1000 patients/year 505.2 readmissions/1000 patients/year
E.g., Hospital readmissions, Stroke 1123.1 readmissions/1000 patients/year 1227.1 readmissions/1000 patients/year

Source: Dobson DaVanzo Associates, Assessment of Patient Outcomes of Rehabilitative Care Provided in Inpatient Rehabilitation Facilities (IRFs) and After Discharge, pages 28-38, Exhibits 4:1-4:10, Assessment of Patient Outcomes of Rehabilitative Care Provided in Inpatient Rehabilitation Facilities (IRFs) and After Discharge, pages 28-38, Exhibits 4:1-4:10. The Costs of Medicare As part of their investigation into whether patients in IRFs had better clinical results, Dobson DaVanzo looked at the expenses of care, both during the patient’s first inpatient stay in either an IRF or an SNF and for the following two years.

  • They also discovered that patients treated in IRFs had slightly higher overall medical costs.
  • It also did not take into account the expenses of nursing home care, which are covered by Medicaid for patients treated in IRFs or SNFs.
  • Early research examined the treatment of patients with hip fractures before and after the establishment of the prospective payment system (PPS) for hospitals, which was divided into diagnosis-based groups (DRGs).
  • Following the implementation of the DRG system, hospital lengths of stay decreased from 22 to 13 days, and the percentage of patients sent to skilled nursing facilities climbed from 38 to 60 percent.
  • The researchers discovered that, for a variety of reasons, “rehabilitation treatment within nursing homes was less successful than inpatient therapy prior to PPS” when PPS was implemented.

Despite the fact that this discovery was “alarming,” the researchers hailed it as their most significant discovery. The expenditures of treatment have migrated from inpatient hospitalization, which is paid for by Medicare, to long-term care, which is paid for through Medicaid. The Costs of Medicare

Issue IRFs SNFs
Average Medicare payment for initial stay for all conditions $14,836 $ 8,861
E.g., Average Medicare payment for initial stay, hip fracture $15,183 $11,019
E.g., Average Medicare payment for initial stay, hip/knee replacement $10,716 $6,506
E.g., Average Medicare payment for initial stay, stroke $19,149 $10,482
Average Medicare payment per-member-per-month (PMPM) for post-hospital rehabilitation period for all conditions $1,815 $1,736
E.g., Average Medicare payment PMPM for post-hospital rehabilitation period for hip fracture $1,679 $1,598
E.g., Average Medicare payment PMPM for post-hospital rehabilitation period, hip/knee replacement $887 $844
E.g., Average Medicare payment PMPM for post-hospital rehabilitation period for stroke $2,227 $2,162
Average Medicare payment per day for all conditions (over two-year period) $82.65 $70.06
E.g., Average Medicare payment per day (over two-year period), hip fracture $78.17 $68.40
E.g, Average Medicare payment per day (over two-year period), hip/knee replacement $43.64 $35.55
E.g., Average Medicare payment per day (over two-year period), stroke $104.41 $88.08

Examining the Outcomes of Rehabilitative Care Provided in Inpatient Rehabilitation Facilities (IRFs) and After Discharge, by Dobson DaVanzo Associates (Dobson DaVanzo Associates), pages 38-42, Exhibits 4:11-4:14. Payments that are not tied to a certain website MedPAC supports the use of site-neutral payments, as stated in its June 2014 Report to Congress: “Site-neutral payments stem from the Commission’s position that the program should not pay more for care in one setting than it should in another if the care can be safely and efficiently (that is, at a lower cost while maintaining high quality) provided in a lower-cost setting.” According to the Center, “safely and efficiently” are not synonymous with “at a cheap cost and with a high level of quality.” While “efficiently” and “at a cheap cost” are often used interchangeably, “safely” and “high quality” are not synonymous with one another.

A post-acute environment may be able to give “safe” treatment, but the quality of the care may not be satisfactory.

In a study conducted by MedPAC, four outcomes for IRF and SNF patients were compared: “hospice readmission rates, changes in functional status, death rates, and total Medicare spending over the first 30 days following release from the qualifying stay.” The findings were “mixed”: SNF patients had higher readmission rates, but outcomes for improvements in function were mixed; death rates for SNF patients were higher in the 30-day period following discharge; and Medicare spending was greater for IRF patients.

  • MedPAC suggested that IRFs be paid at the same rates as SNFs, with some IRF criteria being exempt from payment altogether.
  • MedPAC also indicated that beneficiaries who were treated in SNFs rather than IRFs may have had higher cost-sharing obligations in the future.
  • 1395cc-4, a National Pilot Program on Payment Bundling is established to pay for a “episode of care,” which is defined at 3023(2)(D)(i)(I)-(III) to include a hospital stay and the 30 days following discharge from the hospital.
  • Aiming to facilitate and encourage greater coordination of care among different care locations and providers, bundling payments is intended to accomplish this.
  • Model 2 (of four models), the “retrospective acute and post-acute demonstration,” is a retrospective acute and post-acute care event that begins with hospitalization and continues through post-acute care.
  • According to Model 3, the “post-acute care retrospective demonstration,” the episode of care is started by the acute care hospitalization, but it does not begin until the patient is discharged to the post-acute care environment.
  • Patients who receive services at a lower cost than the goal price can keep the savings; however, patients who receive services at a higher cost than the target price must reimburse Medicare for the difference between the actual expenditures and the target price.

In Model 2, there are 107 participants; in Model 3, there are 43 people.

Inpatient rehabilitation facilities (IRFs) should be offered to Medicare patients who require and may benefit from intense rehabilitation treatments.

What is the purpose/goal of site-neutral payments, and how may they be achieved?

As the Dobson DaVanzo study demonstrates, while IRFs and SNFs serve some of the same patients, they provide very different services and produce significantly different health results for their respective patient populations.

Beneficiaries must have freedom of choice in selecting their post-acute provider, assuming that provider is willing to accept them, in order to participate in the bundling demonstrations.

Is it probable that acute-care hospitals and physician practice groups will guide patients to the post-acute provider of their choosing, which is likely to be the lower-cost SNF option, if they are exposed to financial risk in the demonstrations?

How much flexibility do they now have to make their own decisions?

Along with concerns about appropriate therapy in Model 3, the Center is concerned that, because post-acute care providers “control the bundle,” they may refuse to admit a patient to a more expensive hospital, even when hospitalization is medically necessary, to keep the total actual expenditures for that patient’s episode of care lower than the target price for that episode of care.

Site-neutral payments would almost certainly result in a reduction in payments to IRFs, a reduction in the availability of IRFs for Medicare patients, and an increase in the cost-sharing required of Medicare beneficiaries.

What is your opinion on whether Models 2 and 3 put Medicare patients at risk of having less access to therapy and getting lower results?

The use of site-neutral payments and the demonstrations of bundling appear to be undermining the availability of IRFs for Medicare patients who require post-acute care after a hospitalization.

24, 1988).

CMS is an abbreviation for “Content Management System.” “The Bundled Payments for Care Improvement (BPCI) Initiative provides general information on the initiative.

CMS, “BPCI Model 3: Retrospective Post Acute Care Only,” (BPCI Model 3: Retrospective Post Acute Care Only). Toby S. Edelman, “Bundled Payments for Care Improvement (BPCI) Initiative: General Information,” July 31, 2014 – Centers for Medicare and Medicaid Services.

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