What Is An Inpatient Rehab Facility? (Solution found)

IRFs are free standing rehabilitation hospitals and rehabilitation units in acute care hospitals. They provide an intensive rehabilitation program and patients who are admitted must be able to tolerate three hours of intense rehabilitation services per day.

Inpatient Drug Rehab: Find Treatment Near You – Addiction Center

  • Inpatient rehab is a residential treatment center where patients reside for various lengths depending on their program. The average stay is 30 days, but most addiction treatment facilities offer longer programs (60 days, 90 days or even longer).


What is inpatient rehabilitation services?

Inpatient rehabilitation generally refers to physician and therapy services you receive during a stay in a hospital. Outpatient rehabilitation refers to services you receive when you are not admitted to the hospital, such as physician services and physical, occupational, and speech therapy.

What is the criteria for inpatient rehab?

Rehabilitation Readiness Patient is willing and able to participate in a rehabilitation program. Patient must be able to participate in an intensive therapy program i.e., 3 hours per day, 5 to 6 days per week. Patients require two or more therapy disciplines. Patients require at least a five-day rehab stay.

What is the average length of stay in inpatient rehabilitation?

According to the Center for Medicare Advocacy, the average length of stay for inpatient rehab is 12.4 days, but this includes joint replacement, stroke, and other types of rehab.

What is the difference between inpatient rehab and skilled nursing?

An inpatient rehab facility offers acute care for those who need a higher level of rehabilitation following traumatic injuries and surgeries such as amputations. Skilled nursing facilities, on the other hand, offer subacute rehabilitation, which are similar but less intensive than the therapies provided at an IRF.

Is inpatient rehab considered acute care?

It is not considered acute care unless it takes place in an acute care hospital (e.g. cardiac rehab unit, transitional care unit, acute rehab at a general hospital, etc.). It is considered post-acute care. Acute rehabilitation facilities receive their patients after the acute phases of their illnesses.

Is rehab considered a hospital?

What is a rehabilitation hospital? A medical rehabilitation hospital, also known as an inpatient rehabilitation facility (IRF), is a type of specialty hospital that focuses on treating people recovering from debilitating injuries, illnesses, surgeries, and chronic medical conditions.

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.

Is a rehab center the same as 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.

How many days of rehab are covered by Medicare?

Medicare will pay for inpatient rehab for up to 100 days in each benefit period, as long as you have been in a hospital for at least three days prior. A benefit period starts when you go into the hospital and ends when you have not received any hospital care or skilled nursing care for 60 days.

What is the difference between a skilled nursing facility and a rehab facility?

In a skilled nursing facility you’ll receive one or more therapies for an average of one to two hours per day. 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.

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.

How many days is short term rehab?

The average stay in the short term rehabilitation setting is about 20 days, and many patients are discharged in as little as 7 to 14 days. Your personal length of stay will be largely determined by your progress in terms of recovery and rehabilitation.

What are inpatient hospital services?

Inpatient care generally refers to any medical service that requires admission into a hospital. Inpatient care tends to be directed toward more serious ailments and trauma that require one or more days of overnight stay at a hospital.

What is the difference between inpatient acute 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 does a rehab nurse do?

The rehabilitation nurse is a nurse who specializes in helping people with disabilities and chronic illness attain optimal function, health, and adapt to an altered lifestyle. Rehabilitation nurses assist patients in their move toward independence by setting realistic goals and treatment plans.

Inpatient Rehabilitation Facilities Are Not All The Same

When it comes to intensive, multidisciplinary medical rehabilitation, an Inpatient Rehabilitation Facility (IRF) is the ideal location.

What Is An Inpatient Rehabilitation Facility (IRF)?

When someone requires inpatient therapy and also has medical problems that necessitate round-the-clock nursing care, they are referred to be inpatient rehabilitation patients. Some IRFs are part of a larger healthcare system. Other IRFs may be located within a hospital setting. Other independent rehabilitation facilities (IRFs) are standalone medical rehabilitation facilities. To put it another way, not all IRFs are created equal.

How To Compare Inpatient Rehabilitation Facilities (IRFs)

What should be the first question you ask yourself is, “What level of care am I searching for?” Inpatient Rehabilitation Facilities (IRFs) are facilities that provide intense rehabilitation treatments to patients who have suffered an injury, sickness, or surgical procedure. Rehabilitative services provided in inpatient rehabilitation facilities (IRFs) include physical and occupational therapy, rehabilitation nursing, and speech–language pathology, all of which are overseen by rehabilitation physicians.

Nursing Home– This is a residential environment that provides permanent custodial help to those who need it.

You can compare different facilities, but be certain that you are comparing institutions that provide the same quality of care.

Examine the accreditations of acute medical inpatient rehabilitation institutions from CARF, the Commission on Accreditation of Rehabilitation Facilities, while comparing acute medical inpatient rehabilitation facilities.

Who Are Inpatient Rehabilitation Facilities’ Patients?

Medicare has very rigorous criteria concerning what types of patients can be treated in an IRF, and these limits are strictly enforced. Patients in an IRF must have one of the following criteria in order to constitute 60% of the patient population:

  • Stroke, traumatic or non-traumatic brain damage, and other conditions Spinal cord damage, whether traumatic or non-traumatic
  • Disorder of the nervous system
  • A fracture of the lower extremities has occurred. The replacement of a lower extremity joint is performed. Another type of orthopedic disorder
  • Amputation of the lower extremity or any other type of amputation
  • Osteoarthritis and rheumatoid arthritis are two types of arthritis. The following are examples: major multiple trauma with no brain injury or spinal cord injury, major multiple trauma with brain injury or spinal cord injury
  • A condition known as Guillain-Barre syndrome. Burns

Injuries to the brain caused by trauma or non-trauma Spinal cord damage caused by a violent or non-traumatic event Disorder of the nervous system fracture of the lower extremity; fracture of the lower extremity. Lower extremity joint replacement (arthroplasty); Another type of orthopedic problem; Amputation of the lower extremities or other types of amputation The conditions of osteoarthritis and rheumatoid arthritis are both examples of inflammatory arthritis. The following are examples: severe multiple trauma with no brain injury or spinal cord injury, major multiple trauma with brain or spinal cord injury A condition known as Guillain-Barré syndrome.

Common Misconceptions About Inpatient Rehabilitation Facilities

Rehabilitation centers are all the same. The outcomes of nursing home rehabilitation will be the same as those of acute medical rehabilitation.

Is Bacharach An IRF?

Bacharach Institute for Rehabilitation is a medical rehabilitation facility that also serves as an IRF (Institute for Rehabilitation and Development). Bacharach has received 11 accreditations from the CARF.

Inpatient rehabilitation hospital care

Intensive rehabilitation is provided by rehabilitation hospitals, which are either speciality hospitals or components of acute care hospitals. Inpatient An inpatient is a patient who has been formally admitted to a hospital by a doctor or other medical professional. The majority of inpatient services are covered by Medicare Part A. (hospital insurance). “>rehabilitation treatment provided on an inpatient basis. It is possible that you may require Inpatient Hospitalization Inpatient care is care that you receive after you have been formally admitted to a hospital by a doctor or other medical professional.

(hospital insurance).

The following are examples of common conditions that may need your admission to a rehabilitation hospital: stroke, spinal cord damage, and traumatic brain injury.

Medicare Health insurance coverage is provided by the federal government if you are 65 years old or older, under 65 and have been receiving Social Security Disability Insurance (SSDI) for 24 months, begin receiving SSDI due to ALS/Lou Gehrig’s Disease, or have End-Stage Renal Disease (ESRD) regardless of your age.

“>Among the Medicare-covered services provided by rehabilitation hospitals are the following:

  • Physical, occupational, andSpeech TherapySee Speech/Language Pathology”>speech therapy
  • Medical treatment and rehabilitative nursing
  • Social worker aid
  • Services in the field of psychology
  • Services in orthotics and prosthetics

It is required that your doctor certifies that the care you are receiving is Medically Necessary before you can be reimbursed by Medicare for your rehabilitation hospital stay. If you require all of the following services in order to receive safe and effective care, then you are deemed medically essential. “>medically necessary, which means that you must require all of the following services in order to receive safe and effective treatment.

  • Availability of a doctor at all hours of the day (indicating that you require regular, direct doctor participation, at least once every 2-3 days)
  • Access to a certified nurse with specific training or expertise in rehabilitation at all hours of the day or night
  • If you are not healthy enough to tolerate three hours of therapy per day, you may still be eligible for intensive therapy, which is generally defined as at least three hours of therapy per day (exceptions can be made on a case-by-case basis, so you may still be eligible if you are not healthy enough to tolerate three hours of therapy per day). In addition, a coordinated team of clinicians including at a bare minimum of a doctor, a rehabilitation nurse, and one therapist is required.

Your doctor must also anticipate that your health will improve to the point where you will be able to operate more independently following your hospitalization for rehabilitation. For example, treatment may assist you in regaining the capacity to feed, wash, and dress on your own, as well as to live at home and/or with family members rather than in a nursing home or rehabilitation center. As a result, if you qualify for Medicare-covered care in a rehabilitation hospital, your Out-of-Pocket Costs (also known as out-of-pocket expenses) are those that you must pay because Medicare or other health insurance does not cover them “The out-of-pocket expenses will be the same as they would be for any other inpatient hospitalization.

During the Benefit Period When it comes to hospital and skilled nursing facility (SNF) services, the benefit period is the duration of time that Medicare will pay for those services.

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You must pay a new deductible for each new benefit period that you get.

Home Health Care Services, Inc.

The vast majority of outpatient services are covered by Medicare Part B (Medical Insurance) “>in an outpatient environment

Facts About Inpatient Rehab Versus Outpatient Therapy

Inpatient rehabilitation programs need you to remain in a facility for the duration of your treatment to receive the rehabilitative therapy and care you require. This necessitates admission to a rehabilitation program and continued care there – comparable to a conventional hospital – until the therapy is completed. The length of your stay might range from a few days to a month or more, depending on your specific requirements and circumstances. These short-term programs may be provided in rehabilitation hospitals that are separate from acute-care hospitals, specialist wings of acute-care hospitals, or skilled nursing facilities.

  1. According to the individual needs of each patient, the team will normally comprise rehabilitative physicians and specialists, rehabilitation nursing staff, physical, occupational, and speech therapists, dietitians, social workers, counselors, and care coordinators, among others.
  2. During your stay, you may also expect to have access to in-house rehab equipment, facilities, and personnel, which will allow you to continue working toward your recovery objectives between treatment sessions in a safe, supervised setting.
  3. All meals and personal care will be given, and many inpatient rehab facilities provide a variety of amenities, such as indoor pools and/or spas, internet access, and/or recreational facilities, to help patients recover faster.
  4. Physical, occupational, and speech therapy are some of the services that are commonly provided in an outpatient rehabilitation program.
  5. Appointments can be booked on any number of days of the week from one to five days per week.
  6. In the majority of situations, patients are asked to do the exercises and tasks prescribed to them by their therapists outside of their scheduled appointments at home between sessions.

When Inpatient Rehab Might Be Your Best Option

Under specific conditions, short-term inpatient rehabilitation may be advised as the most effective treatment choice for your recovery and rehabilitation. Depending on your situation, inpatient rehabilitation may be an excellent choice if you have suffered a catastrophic accident or have had joint replacement or other difficult orthopedic surgery. The rigorous counseling and thorough care that rehab facilities provide may be the most effective means of addressing your aftercare and rehabilitation needs in order to guarantee that you can achieve the best – and most safe – possible recovery in such circumstances.

  1. To achieve the safest and most effective recovery possible in such circumstances, intensive medical monitoring and extensive, multidisciplinary treatment provided in this context are almost certainly required.
  2. Prior to returning home, a stay in an inpatient rehab program may be precisely what you need to restore functional capacity and/or learn to operate around your impairments.
  3. A high-intensity inpatient rehab program can accelerate your progress, and having someone take care of all of your daily requirements – including meals, prescriptions, and care management – can free up your time and energy so that you can concentrate on your rehabilitation.
  4. Just a few instances of how an inpatient rehab stay may be the ideal option for you while recovering from a medical condition or incident are provided below to illustrate the point.

If you are confused about whether or not you require this level of care, your healthcare professionals or hospital discharge planners can assist you in determining the best course of action for your particular situation.

How Inpatient Rehab Physical Therapy Can Help Several Conditions

Inpatient rehabilitation is a critical component of your recovery. Physical therapy can be beneficial for a variety of ailments, including these five. Recovery from Joint Replacement Inpatient rehabilitation for joint replacement therapy is a viable alternative for patients who want to heal more quickly and completely. It can also lower the chance of post-surgery problems and injuries by providing assistance and support throughout the healing and rehabilitation processes. Recovery after a Stroke After a stroke, according to the American Stroke Association’s recommendations, inpatient rehab physical therapy provides the greatest possible setting for rehabilitation.

Arthritis Treatment and Management Inpatient rehabilitation therapy has proven to be beneficial for many persons who suffer from arthritis.

Recovery after a Heart Attack An inpatient cardiac rehabilitation program can help cardiac patients heal more fully before returning to their homes.

Joint Replacement Therapy at an Inpatient Rehab Center

In the event that you want to have a joint replacement in the near future, preparing for your recuperation is an essential stage in the process. It is possible that the care and counseling you receive after the procedure will be equally as vital as the procedure itself. An inpatient rehabilitation center treatment program might be a critical step in achieving a full and speedy recovery. Among the many advantages of inpatient treatment are the following:

  • Therapy and treatment that is more intensive
  • Comprehensive care and support
  • And Having consistent access to rehabilitative personnel, equipment, and facilities

In addition, an inpatient rehab facility can relieve you of some of the domestic responsibilities you would normally be responsible for, such as food shopping, errands, dinner preparation, cleaning up, and laundry.

Inpatient Rehab for Stroke Recovery

It’s important to review all of your alternatives before making a decision on whether to pursue inpatient or outpatient stroke rehabilitation therapy. Outpatient treatment programs often begin with an examination to determine therapeutic requirements, followed by the development of a treatment plan. From then, patients will often be required to attend one to three hour treatment sessions many times each week for the remainder of their lives. An inpatient treatment program is more intense than an outpatient treatment program.

In addition to choosing which treatment option is best for a patient, there are stroke rehabilitation recommendations to follow.

In addition, it has been shown that a minimum of three hours of therapy each day is the most beneficial for stroke recovery in studies.

The decision to seek outpatient or inpatient rehabilitation is ultimately up to the patient and their family, as is the determination of how much support they will require to recover to the best of their abilities.

Why Inpatient Treatment is Needed for Cardiac Care

When someone has a cardiac episode, it is possible that they will require inpatient therapy. There are several reasons why inpatient rehab might be more useful than outpatient rehab, whether it is for a planned operation or an unexpected incident such as a heart attack. First and foremost, it is possible that extensive medical supervision and care may be required. Once a patient has been discharged from the hospital, they may not be ready to return to their regular lives. A secure and supportive environment in which to recuperate from heart surgery is provided through inpatient cardiac care.

This assistance is provided by a multidisciplinary team of cardiac care/rehabilitation experts, which includes doctors, nurses, physical, occupational, and speech therapists, psychologists, nutritionists, and care coordinators, among others.

The likelihood is that if your doctor has recommended inpatient treatment, you should at the very least give it some serious consideration.

How Inpatient Care Can Be Beneficial

When it comes to managing your rehabilitation, there are four main reasons why inpatient treatment might be advantageous. Find out whether any of these explanations correspond to your own personal rehabilitation requirements. Recovery management is made simpler. An inpatient short-term rehab program can offer you or a loved one with the expert treatment they require in a short amount of time. This means that you may concentrate on your rehabilitation while specialists assist you with areas such as wound care, medication management, and other concerns.

This implies that all of your recuperation will take place in a single location, and the personnel will be able to interact well with one another.

Additionally, you will receive more rigorous rehabilitative treatment in addition to your complete care.

Patients in an inpatient program, on the other hand, get a minimum of three hours of therapy each day on a daily basis.

When patients are discharged from the hospital, they may be feeling better, but they are not always ready to take care of themselves at this point – which is why inpatient care is an excellent option for preparing them to return home.

Critical Inpatient Services

There are a few key services that patients receive when they attend a residential drug and alcohol treatment program, in addition to the high level of care they receive. Among the most important aspects of the rehabilitation process are the following:

  • A diverse team of rehabilitative professionals will conduct an evaluation and provide therapy. Rehabilitation therapy that is intensive
  • Specialized rehabilitation programs and care services for certain medical disorders are available. Care, aid, and support available around the clock

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When Outpatient Rehabilitation Services Are Appropriate

In the case of minor injuries, illnesses, or medical occurrences, outpatient treatments may be a viable choice to help in the healing and rehabilitation of the patient. However, it is crucial to highlight that outpatient care is a treatment option that is best suited for persons who are confident in their ability to handle the intricacies of their own care and rehabilitation, such as those who have high levels of strength, function, mobility, and independence. If you decide to recuperate and rehabilitate in your own home, the following are some of the details you will most likely need to take care of on your own or with the assistance of family or friends:.

Your healthcare team and/or hospital discharge planner should be able to assist you establish what your requirements are and whether there are services available in your region that can help you meet those needs safely, efficiently, and effectively if you are unsure.

Inpatient Rehab Versus Outpatient Therapy: Insurance Matters

Ideally, decisions concerning inpatient vs outpatient therapy would be made in accordance with your individual medical, personal, and therapeutic requirements and preferences. However, in the real world, this is not the case. When making these selections, however, the majority of us must take our financial situation into consideration. Consequently, what information do you want on health-insurance benefits, rehabilitation treatment, and care alternatives for yourself or a loved one? You will be required to provide paperwork demonstrating that you have a medical need for rehabilitative treatments in order to be reimbursed for the costs of these services by the majority of insurance providers, including government health insurance programs and commercial insurers.

  • In general, demonstrating a need for rigorous rehabilitative therapy and treatment, as well as round-the-clock medical and nursing care, is required to obtain reimbursement for inpatient rehabilitation.
  • If your documentation demonstrates that a less intense level of treatment is sufficient for your requirements and/or skill levels, outpatient rehab may be the only alternative that your insurance plan is willing to fund under certain circumstances.
  • Make a point of discussing any challenges or limitations that you are concerned about.
  • If you believe that your safety may be jeopardized during the early stages of recovery owing to a lack of assistance and support at home, your medical staff should be made aware of this.

This information is necessary for an accurate assessment of your care needs, which will help you to get the insurance coverage you require to pay for the right amount of rehabilitative treatment. Return to the top of the page

Does Your Loved One Need an Inpatient Physical Rehabilitation Center?

So, how can you determine whether or not your loved one need the services of an inpatient physical rehabilitation center? As we previously discussed, there are several key differences between inpatient and outpatient care that can help you evaluate which option is best for your family member. It is generally accepted that hospitalization is more intense than outpatient treatment. This might entail a minimum of three hours of therapy each day, which could include physical, occupational, and speech therapy.

Instead, outpatient rehabilitation programs involve treatment sessions lasting 30 minutes to an hour only 2 or 3 days per week, which may be completed in as little as 2 or 3 hours.

The following are examples of conditions that may necessitate inpatient treatment:

  • Hip fractures, joint replacement surgery, and other orthopedic operations are all possibilities. A stroke that left a person with substantial disabilities
  • Having a heart attack or having cardiac surgery
  • Diseases such as Parkinson’s disease, Alzheimer’s disease, or dementia
  • COPD or other kinds of lung illness
  • And others. A diabetic patient was admitted to the hospital for problems. Patients suffering from severe osteoporosis
  • Patients suffering from disabilities caused by advanced arthritis

Still not sure if inpatient rehabilitation is the best option for you? Contact Rehab Select to learn more about the various treatment alternatives available. Return to the top of the page

Inpatient Rehabilitation Care Coverage

Part A of the Medicare program covers inpatient hospitalizations, skilled nursing facility care, hospice care, and a portion of home health care.” about=”/node/32351″ role=”article” about=”/node/32351″> Health care services or supplies required to diagnose or treat an illness, accident, ailment, disease, or its symptoms and that satisfy established standards of medicine are covered under Medicare Part A (Hospital Insurance).

  • The medically required treatment you get in an inpatient rehabilitation facility or unit (also known as an inpatient “rehab” facility, IRF, acute care rehabilitation center, or rehabilitation hospital) is described in more detail below.
  • Your Original Medicare expenses are as follows: You are responsible for each.
  • A benefit period begins on the day that you are admitted as an inpatient to a hospital or skilled nursing facility (SNF).
  • If you are admitted to a hospital or a skilled nursing facility after one benefit term has expired, a new benefit period will begin.

For each benefit period, you are responsible for paying the inpatient hospital deductible. A person may get benefits during an unlimited number of time periods.” benefit period: role=”article” about=”/node/32116″> role=”article” about=”/node/32116″>

  • The first 60 days are deductible at the rate of $1,556. 61st to 90th days: $389 coinsurance per day
  • For each “lifetime reserve day” after day 90 for each benefit period (up to a total of 60 days during your lifetime), you will be responsible for $778 in coinsurance. Every day after the lifetime reserve days incurs the following expenses:
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*If you were previously charged a deductible for care received during a prior hospitalization within the same benefit period, you will not be required to pay a deductible for care received in an inpatient rehabilitation facility. This is due to the fact that your benefit period begins on the first day of your previous hospital stay, and that hospital stay counts against your deductible. As an illustration:

  • Following your discharge from an acute care hospital, you are transported to an inpatient rehabilitation center. Inpatient rehabilitation is required if you are admitted to a facility within 60 days after being discharged from the hospital.

What it is and how it works Acute inpatient rehabilitation can be beneficial if you’re recovering from a serious surgical procedure, illness, or injury and require a comprehensive rehabilitation therapy program under physician supervision, as well as your doctors and therapists working collaboratively to provide you with coordinated care. Medicare provides coverage for the following:

  • Physical therapy, occupational therapy, and speech-language pathology are all examples of rehabilitation therapies available. A semi-private room
  • Meals
  • Nursing services
  • Drugs
  • And other amenities Various more healthcare services and supplies are available.


  • Nursing services on a private basis
  • Your own telephone and television in your room
  • Toiletries and other personal things such as toothpaste, socks, and razors (unless when a hospital supplies them as part of your hospital admittance kit)
  • When medically essential, a separate room is provided.

Things to be aware of

During the COVID-19 pandemic, inpatient rehabilitation facilities may accept you from an acute-care hospitals experiencing a surge, even if you don’t require rehabilitation care.

Medical insurance under Part B (Medical Insurance) covers certain doctors’ services, outpatient care, medical supplies, and preventive services.” role=”article” about=”/node/32356″> Medicare Part B (Medical Insurance) covers doctors’ services received while a patient is a patient in an inpatient rehabilitation facility.

Is my test, item, or service covered?

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

Frequently Asked Questions About Inpatient and Outpatient Rehab

What exactly is the difference between inpatient, outpatient, and transitional rehabilitation? Inpatient rehabilitation is a term that refers to the medical and therapy treatments you receive while undergoing treatment in a hospital. Generally speaking, outpatient rehabilitation refers to therapies that you receive while you are not hospitalized to the hospital. These services include medical services as well as physical, occupational, and speech therapy. Transitional rehabilitation units (TRUs) are short-term rehabilitation facilities that are designed to address the requirements of patients who have been discharged from the hospital but are not yet ready to return home.

What is the role of a physiatrist?

Physiatrists diagnose and treat disorders using the following methods:

  • Techniques for physical rehabilitation
  • Medical treatment
  • Pharmacotherapy

They use a comprehensive approach to patients in order to:

  • Improve function
  • Overcome physical constraints
  • Avoid impairment

Inpatient Rehabilitation

Who is the target audience for inpatient rehabilitation? The UPMC Rehabilitation Institute accepts patients who have been diagnosed with a disease that needs the services of an acute inpatient rehabilitation program, such as daily rehabilitation nursing and physician care, before they may be admitted. Then, in order to engage in inpatient therapy, you must meet the following requirements:

  • Be in good health medically
  • Have functional deficiencies or requirements that can be met via the use of rehabilitation approaches
  • And Be able to tolerate and reap the benefits of three hours of a variety of professional treatments — physical, occupational, and speech — spread throughout the day. Consider that progress toward functional objectives will be made within a realistic time period

How does the staff know what my specific recovery objectives are? Prior to admission or at the time of admission, the institute staff meets with you and your family to discuss your rehabilitation goals and to provide you with the information you need to answer any questions you might have. You and your treatment team will discuss the following topics during your initial assessment and throughout your rehabilitation stay:

  • Your objectives
  • Your progress in achieving your objectives
  • Any obstacles that stand in the way of accomplishing your objectives

What is the process for being referred to the UPMC Rehabilitation Institute? Physiatrists or rehab liaisons will be consulted if your physicians or physical therapists believe you require inpatient rehabilitation. These professionals will examine your medical condition as well as your progress in therapy. Once it is determined that your needs meet the criteria for acute inpatient rehabilitation, the rehab liaison will work with you to give more education and to discover potential institutions.

What forms of insurance do you take, and what do you charge? Many different insurance carriers are accepted by the UPMC Rehabilitation Institute. If you have any insurance issues, your admissions agent or rehab liaison can assist you. Alternatively, you can contact 1-877-AT-REHAB (28-73422).

Your Stay at the UPMC Rehabilitation Institute

What amount of therapy will I receive on a daily basis? Your patient care team creates a treatment plan that is unique to your situation. Patient rehabilitation at the UPMC Rehabilitation Institute is typically three hours per day, five days a week, with the exception of weekends and holidays. You will be required to utilize the skills you have gained in treatment throughout the rest of your day in order to be ready for release when the time comes. How often will I be seen by a doctor? How you should proceed is determined on your specific circumstances.

Is it possible for family members to visit me while I’m in the hospital?

We urge you to bring your family and friends to visit.

Your family and friends, in addition to you, are a significant element of this team’s composition.

Outpatient Rehabilitation

What types of ailments do you address on an outpatient basis? Physiatrists are trained to treat a wide range of illnesses and ailments, including the following:

  • Neurological and spinal cord injuries
  • Stroke
  • Muscular-skeletal problems
  • Adult spina bifida
  • Amputation
  • Joint replacement
  • Pelvic, prenatal, and postpartum discomfort
  • And other conditions Back discomfort in the lower back Arthritis, work-related injuries, sports-related and overuse injuries, to name a few.

Physical, occupational, and speech therapists also treat a wide range of ailments and injuries on an outpatient basis, including the following conditions and injuries:

  • Arthritis, back, shoulder, and neck discomfort, facial and jaw pain, and other conditions Balance issues
  • Inner ear issues
  • Hand injuries and carpal tunnel syndrome
  • And other issues. Injuries or discomfort in the knees and legs
  • Lymphedema
  • Diseases of the nervous system
  • Abnormalities of the voice
  • Disorders of swallowing Injuries sustained when participating in sports
  • Injuries sustained while working

Fact Sheet: Inpatient Rehabilitation Facilities – A Unique and Critical Service

The AHA Center for Health Innovation conducted a market analysis. Service lines are still being disrupted by COVID-19, and there appears to be no end in sight. The health-care personnel is stressed and overworked as a result of the so-called economic downturn. A rural, not-for-profit, community-owned acute-care teaching hospital in Klamath Falls, Oregon, Sky Lakes Medical Center (SLMC) is an internationally certified acute-care teaching hospital. With a number of significant concerns to address before the end of the year, Congress is back in Washington, D.C.

Congress might take action as early as this week.

With the consequences of COVID-19 anticipated to last for some time, providers may anticipate that many of the trends that have emerged during the previous two years will remain.

HH agencies and their hospital and other local partners will be able to concentrate on responding to the COVID as a result of CMS’s publication of a simplified regulation.

Why Inpatient Rehabilitation

When compared to skilled nursing, home health, or outpatient therapy services, inpatient rehabilitation is the most intensive degree of physical rehabilitation that a patient may get. Intensive multidisciplinary treatment under direct physician supervision is used to effectively handle medical conditions so that patients may optimize their involvement in rehab while experiencing less discomfort and better endurance. The vast majority of our patients are transferred to us after being stabilized in an acute care hospital, while some are admitted straight from the community as well.

Patients should be able to devote three hours per day, five days per week to therapy in the ideal situation.

Alternatively, for patients who are still working on increasing their endurance, we may provide an alternate program that involves slightly more than two hours of therapy every day, seven days a week.

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Read on to find out more While the length of treatment time may appear daunting to some, our team members work with each patient individually in a secure, cutting-edge setting to develop a realistic treatment plan that allows everyone to reach their goals before returning home to their families. Our team members work together in a collaborative manner, each contributing their unique knowledge to suit the specific needs of each individual. Our multidisciplinary team consists of, but is not limited to, physicians, medical psychologists, rehabilitation nurses, physical therapists, occupational therapists, speech therapists, respiratory therapists, recreation therapists, wound care specialists, and case managers/social workers, among other professionals.

What are Typical Inpatient Diagnoses?

According to the categorization standards established by our regulating authorities, the following are the most often seen diagnoses:

  • Stroke, spinal cord injury, congenital deformity, amputation, major multiple trauma, hip fracture, and brain injury are just a few of the conditions that can occur. Neurological disorders such as multiple sclerosis, amyotrophic lateral sclerosis, Parkinson’s disease, motor neuron illnesses, polyneuropathy, and muscular dystrophy are included in this category.

Patients frequently suffer from a number of medical issues, all of which must be adequately addressed by a physician in order for them to be able to engage in therapy and set the stage for a long-term recovery. There are normally two alternatives for those seeking rehabilitation services: an inpatient rehabilitation facility (IRF) or a skilled nursing facility (SNF) (SNF). The table below outlines the distinctions between different rehabilitation alternatives to assist you in determining which rehabilitation option best matches your or your loved one’s current medical needs at this time.

Service Inpatient Rehab Facility Typical Skilled Nursing Facility
Physician Visits Daily 1-3 Times per Week
Type of Physicians Physiatrist, a doctor who specializes in Physical Medicine and Rehabilitation (24-hour availability) Geriatrician, Internist, or Nurse Practitioner (Limited availability)
Consultants All specialties readily available Limited specialist availability
Nursing Hours of Care 24-hour availability, 5.5 or more hours of 1:1 hands-on care per day, primarily registered nurses 2-3 hours daily, primarily certified nursing assistants
Nursing Skill Mix Professional registered nurses specializing and certified in rehabilitative nursing Nursing assistants certified in long-term care with LPN/RN supervision
Integration of Care Coordinated interdisciplinary team directed by assigned physician who specializes in physical medicine and rehabilitation Several individual disciplines
Average Length of Stay 10-35 days, depending on diagnosis 12-45 days with possible transition to long-term care based on progress
Therapy Intensity 15 hours per week 30-70 minutes, 3 to 5 times per week with schedule subject to vary
Team Meetings Interdisciplinary physician-led team meetings including patient, family, and supports Several individual disciplines and social worker
Rehab Psychology Full-time Limited
Physical and Occupational Therapy Licensed physical and occupational therapists Physical therapist assistants and certified occupational therapy assistants deliver much of the care
Speech Language Therapy, Therapeutic Recreation, Social Worker Full-time Limited
Admission Evaluated by licensed clinician and reviewed by medical doctor Accepted by admissions department

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.

Dobson DaVanzo conducted two analyses on a total of 100,491 matched pairs of patients with the same conditions (representing 89.6 percent of IRF patients and 19.6 percent of SNF patients throughout the research period), using data from the National Center for Health Statistics.

  • 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.

  1. They also discovered that patients treated in IRFs had slightly higher overall medical costs.
  2. 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.
  3. 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).
  4. 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.
  5. 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.

  1. MedPAC suggested that IRFs be paid at the same rates as SNFs, with some IRF criteria being exempt from payment altogether.
  2. MedPAC also indicated that beneficiaries who were treated in SNFs rather than IRFs may have had higher cost-sharing obligations in the future.
  3. 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.
  4. Aiming to facilitate and encourage greater coordination of care among different care locations and providers, bundling payments is intended to accomplish this.
  5. 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.
  6. 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.
  7. 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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