Therapy Begins at the Rehabilitation Center
I recently met with a family who was looking to send their loved one to one of our Rehab facilities after a short stay at the hospital.
One of the first things families are nervous about, is whether we believe their loved ones will be able to tolerate therapy post-hospitalization and if so, in what measure?
The fact is, the job of any post-acute rehabilitation center is to provide the patient with a high level of therapy (offering all 3 disciplines) so as to facilitate a safe transition to home.
For most patients, the idea of returning to home directly from the hospital is virtually impossible.
They need that stepping stone in-between in order to heal and recover properly. This is where rehabilitation centers come in.
Why Hospitals Provide Little (or None) Physical Therapy
This family I met with expressed their concern regarding the fact that the hospital really didn’t provide their mom with any rehab for the almost two weeks that she was there, save for a therapy evaluation and a day or so of therapy towards the very end and right prior to her discharge.
They felt that the hospital was somehow remiss in not fulfilling their duties and worried that this would adversely impact our ability to provide her with a successful therapy regimen upon her admission to our facility.
As this isn’t the first time I’ve heard such concerns articulated by anxious families, I think it important to publish the following perspective in order to empower folks who are faced with similar circumstances.
The fact of the matter is that most hospitals are not tasked with the obligation or the mandate to provide in-patient therapy. A hospital is considered an acute environment and as such, their objective is first and foremost to stabilize the patient so that he or she is no longer in an emergency situation.
Once the acuity phases away, it is only then that the patient should begin the road to physical healing and recovery by incorporating a structured program of in-patient “post-acute” rehabilitation.
How Hospitals Work with Rehabs
The fact that hospitals do a screening and evaluation for Physical Therapy (and in some instances, begin providing therapy prior to discharge) is simply to develop a baseline for the accepting post-acute rehabilitation center to be able to extrapolate as to what the rehab goals will be for each particular patient.
This information isn’t simply important as a tool for developing a tailor-made program of rehab for each individual patient, but more importantly, it is used as a means of determining altogether whether such an admission is feasible.
You see, short term rehab is typically synonymous with Medicare. Medicare provides reimbursement to the facility only if/when the patient can demonstrate (and ultimately achieve) sustainable goals with respect to their therapy.
The fact that patients have available Medicare benefits doesn’t guarantee that they are able to use these benefits for in-patient rehab.
Instead, they must be capable of receiving therapy in a manner and measure which will allow them to achieve their prior level of functioning.
That is the job and the goal of the admitting rehab facility and it is the reason the hospitals will offer a therapy evaluation and PT notes to the facility prior to the discharge.
However, where the work really commences in earnest is at the post-acute center.
I therefore encouraged this family (and all future families who are reading this), not to lose hope or be disheartened.
On the contrary, they should be happy that the condition of their loved one no longer justifies an acute hospitalization and that they are now ready for a discharge to a post-acute rehabilitation center and are one step closer to home!