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Acute Rehab-The Basics

Acute rehabilitation is an intensive form of medical rehabilitation in which patients receive three or more hours of core therapies per day (physical therapy, occupational therapy and speech therapy). In acute rehabilitation settings, patients are cared for by a team of clinicians from a wide variety of medical fields.

Typical Admission Criteria for Acute Rehabilitation Hospitals (Acute Rehab)

Inpatient Functional Admission Criteria

  • The Patient has experienced a substantial loss in more than one domain of function due to the recent onset or change in their medical condition.

  • There is the potential to achieve substantial improvement in one or more domains of function if they are provided with a physician directed goal driven program.

  • The program must consist of and the patient must tolerate rehabilitation including two or more skilled therapies totaling at least three hours of therapy time, five days per week.

  • Patient requires daily physician oversight by a physician with specialized rehabilitation training.

  • Patient requires 24 hours per day specialized rehabilitation nursing care and oversight.

Inpatient Medical Criteria

  • The patient has achieved moderate medical stability.

  • A patient's special medical needs are within the scope of services of the facility.

  • The patient's medical work-up and/or outstanding diagnostic tests have been completed.

Inpatient Psycho-social Criteria

  • The patient wants to fully participate in the rehabilitation process.

  • The patient intends to be discharged home or to a community-based setting.

  • Family support when needed is available.

  • Insurance approval and/or other financial arrangements have been secured.

60% of an acute rehab patients at any given time must have one of 13 Medicare-approved diagnosis:

  • Stroke

  • Spinal cord injury

  • Congenial deformity (e.g. cerebral palsy, cerebrovascular malformations)

  • Amputation

  • Major multiple trauma

  • Hip fracture

  • Brain Injury

  • Neuro disorder (e.g. multiple sclerosis, Parkinsons)

  • Burns

  • Active, polyarticular arthritis, psoriatic arthritis

  • Systemic vasculidities with joint inflammation

  • Severe or advanced osteoarthritis including 2 or more major weight bearing joints

  • Knee/hip replacement (only if bilateral, BMI 50+, or if 85+)

The other 40% can be from other diagnoses e.g. deconditioned or debility if they meet the requirement for medical necessity.

How is it Paid For?

Medicare Part A (hospital insurance) pays 100% for the first 60 days, as this is considered a hospital level of care, as long as patients have met their $1484 deductible for the benefit period (most people meet this during the hospital admission leading to the rehab transfer). Days 61-90 result in a daily $371 copay. Most managed care plans cover acute rehab, but require pre-authorization and approval, Some private insurances also cover acute rehab. All insurance plans follow Medicare guidelines for admissions (required/approved diagnosis).

If you Don't Qualify for Acute Rehab but Still Need Some Rehabilitation and/or Nursing Care There are Other Options.

Sub Acute Rehabilitation- Commonly known as Skilled Nursing Facility (SNF) Sub acute level care is less intensive than acute rehabilitation. Although a combination of physical, occupational and speech therapy may be provided in the sub acute setting, the number of hours each patient receives is lower. Generally, patients in a sub acute facility only receive between one and two hours of therapy per day. The average length of stay at a sub acute facility is also generally longer than at an acute hospital

Home Health Care

Home health care is a wide range of health care services that can be given in your home for an illness or injury. Services can include nursing, physical, occupational and speech therapy and social work. and are provided in your home about 1-3 times per week. (depending on specific needs).

Best Concierge Nurse Case Management

Can provide assistance with post acute care needs/choices

AR, SNF, HHC (what does all that mean)!

Is the hospital or care center recommending additional services when it is time to discharge? They will give you a list of options, but it is just that, a list. What does all that jargon mean? SNF, AR, HHC? Medicare Star Ratings? How do you know if the next level of care is really right for you and/or your loved one? How do you choose a facility, or agency? We can provide more information and insight into each area and assist in selecting the appropriate next level of care and specific facility, agency or service.

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