Mystery Solved: Which Patients Are Good Candidates For Acute Inpatient Rehabilitation?

Occupational Therapy Environment, Saint Luke's Hospital, WA For most physicians who practice inpatient medicine, acute inpatient rehabilitation facilities are mysterious places with inscrutable admissions criteria. This is partly because physical medicine and rehabilitation (PM&R) has done the poorest job of public relations of any single medical specialty (Does anyone know what we do?), and also because rehab units have been in the cross hairs of federal funding cuts for decades. The restrictive CMS criteria for inpatient rehabilitation have resulted in contortionist attempts to practice our craft in an environment where clinical judgment has been sidelined by meticulous ICD-9 coding. But I will not bore you with the reasons behind our seemingly capricious admissions criteria. Instead I will simply tell you what they are in the simplest way possible. After much consideration, I thought it would be easiest to start with the contraindications to acute rehab – I call these “red lights.” If your patients have any of these, then they will not qualify for transfer to the acute inpatient rehab unit. I followed the absolute contraindications with relative contraindications (you guessed it, “yellow lights”) – these patients require some clinical and administrative judgment. And finally, I’ve listed the official green lights – the diagnosis codes and medical necessity rules for the ideal inpatient rehab candidate. I hope that the...
Source: Better Health - Category: American Health Authors: Tags: Health Policy Health Tips 60% Rule Acute Inpatient Rehabilitation Acute Rehab Admissions Coordinator Admissions Criteria Admissions Guidance ARF ARU Case Manager CMS Hospitalists Physical Medicine And Rehabilitation PM&R Rule Source Type: blogs